Stanley Blyskal, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

124015 Issued in NY

Practice address

126 E Main St
Ste 1
East Islip, NY 11730-2600

Phone

(631) 581-0090

Fax

(631) 581-2879

NPI assigned

Jul 5, 2006

Last updated

Mar 25, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1063443257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST",
            "address_2": "STE 1",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302600",
            "telephone_number": "631-581-0090",
            "fax_number": "631-581-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST",
            "address_2": "STE 1",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302600",
            "telephone_number": "631-581-0090",
            "fax_number": "631-581-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLYSKAL",
        "first_name": "STANLEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "124015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00425489",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Ann Bianchi, RN
• Brooke L Bickford
• Edward J Bieniewicz, MD
• Lauren Bilello, M.S., SLP
• Carol Grace Bishop, RN
• Julie Boerger, D.M.D.
• Linda O Bogarowski
• Victoria Bonomo, NP
• Laura Kristine Bowen, D.C.
• Edana Brady, LPN

• Family Medicine Physician in East Islip, NY
• Providers in East Islip, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.