Provider Demographics
NPI:1477745529
Name:BLISKO, ANTHONY (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:BLISKO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 SAWKILL RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-1208
Mailing Address - Country:US
Mailing Address - Phone:845-331-6233
Mailing Address - Fax:845-331-5121
Practice Address - Street 1:134 SAWKILL RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-1208
Practice Address - Country:US
Practice Address - Phone:845-331-6233
Practice Address - Fax:845-331-5121
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0039711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor