Provider Demographics
NPI:1669472080
Name:BLESSIOS, GEORGE A (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:A
Last Name:BLESSIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 ORCHARD PARK RD
Mailing Address - Street 2:A103
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2646
Mailing Address - Country:US
Mailing Address - Phone:716-677-5500
Mailing Address - Fax:716-677-5008
Practice Address - Street 1:550 ORCHARD PARK RD
Practice Address - Street 2:A103
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2646
Practice Address - Country:US
Practice Address - Phone:716-677-5500
Practice Address - Fax:716-677-5008
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219980204F00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1711188OtherINDEPENDENT HEALTH
NY02162334Medicaid
NY219980-0-OBOtherWORKERS COMPENSATION
NY020049862OtherRAILROAD
NY040426002483OtherFIDELIS
NY9511513OtherGHI PPO
NY00025531801OtherUNIVERA
NY000526338001OtherBC/BS
NYCC4732Medicare PIN
NY020049862OtherRAILROAD