Provider Demographics
NPI:1790840494
Name:BLANDINO, RAMON ARTURO (LIC FAMILY THERAPIS)
Entity Type:Individual
Prefix:MR
First Name:RAMON
Middle Name:ARTURO
Last Name:BLANDINO
Suffix:
Gender:M
Credentials:LIC FAMILY THERAPIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39-26 CLEARVIEW EXPRESSWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361
Mailing Address - Country:US
Mailing Address - Phone:917-533-0507
Mailing Address - Fax:
Practice Address - Street 1:39-26 CLEARVIEW EXPRESSWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361
Practice Address - Country:US
Practice Address - Phone:917-533-0507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000610-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000610-1OtherLIC. FAMILY THERAPIST