Provider Demographics
NPI:1184933954
Name:RICHARD L BLANSKY PLLC
Entity type:Organization
Organization Name:RICHARD L BLANSKY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-770-1155
Mailing Address - Street 1:161 RIVERSIDE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4176
Mailing Address - Country:US
Mailing Address - Phone:607-770-1155
Mailing Address - Fax:607-770-1968
Practice Address - Street 1:161 RIVERSIDE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4176
Practice Address - Country:US
Practice Address - Phone:607-770-1155
Practice Address - Fax:607-770-1968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184290207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty