Provider Demographics
NPI:1225318207
Name:BLAZSEK, ERIC JOSEPH (LPMHC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:JOSEPH
Last Name:BLAZSEK
Suffix:
Gender:M
Credentials:LPMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ENDOR AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4609
Mailing Address - Country:US
Mailing Address - Phone:718-420-1521
Mailing Address - Fax:
Practice Address - Street 1:57 SAINT MARKS PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-7902
Practice Address - Country:US
Practice Address - Phone:212-982-3470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health