Provider Demographics
NPI:1932344363
Name:BLASINI, JOE A (TS)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:A
Last Name:BLASINI
Suffix:
Gender:M
Credentials:TS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B3 EXT SAN JOSE
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-4017
Mailing Address - Country:US
Mailing Address - Phone:787-205-3286
Mailing Address - Fax:787-845-1188
Practice Address - Street 1:AVE. LUIS MUNOZ RIVERA 91
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-205-3286
Practice Address - Fax:787-845-1188
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
PR104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker