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EDISON R. BLANCO PHYSICIAN PC
NPI 1669631032
Family Medicine in Bay Shore, NY

Active since June 02, 2008
16 BRENTWOOD RD, BAY SHORE, NY 11706(631) 969-7875 Get Directions Write a Review

NPPES record last updated: September 8, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edison R. Blanco Physician Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDISON R. BLANCO PHYSICIAN PC (NPI 1669631032) is a healthcare organization registered as a family medicine in Bay Shore, New York and active in the NPI registry since June 2008. The organization lists Edison Roque Blanco, Owner, as its authorized official.

NPPES Registry Identity

NPI1669631032
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEDISON R. BLANCO PHYSICIAN PC
Location Address16 BRENTWOOD RDBay Shore, NY 11706-8011
Mailing Address16 Brentwood RdBay Shore, NY 11706-8011 · (631) 969-7875
Phone(631) 969-7875
Organization SubpartNo
Authorized OfficialEdison Roque BlancoOwner · (631) 969-7875
Enumeration DateJune 2, 2008
Last NPPES UpdateSeptember 8, 2008
✔ NPI 1669631032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 189607
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
16 BRENTWOOD RD, Bay Shore, NY 11706
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Other Identifiers 3

Medicare PINWEY031NY
Medicare UPINF33401NY
Medicaid01634335NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EDISON ROQUE BLANCO M.D.
Family Medicine
16 BRENTWOOD RD
BAY SHORE, NY 11706
Suffolk County (631) 969-7875
DR. PAUL JOSEPH BROOKE DC
Chiropractor (Rehabilitation)
16 BRENTWOOD RD
BAY SHORE, NY 11706
Suffolk County (631) 666-6661

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edison R. Blanco Physician PC's NPI number?

The NPI number for Edison R. Blanco Physician PC is 1669631032. It was assigned to this organization in the NPPES registry on June 2, 2008.

Where is Edison R. Blanco Physician PC located?

Edison R. Blanco Physician PC is located at 16 Brentwood Rd, Bay Shore, NY 11706. The listed phone number is (631) 969-7875.

What is Edison R. Blanco Physician PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Edison R. Blanco Physician PC was last updated on September 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.