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NPI Code Detail

MEDICARE: MARK BLAZEY MS, CRNA

MEDICARE:   MARK  BLAZEY  MS, CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN2266306MA
2367500000XCertified Registered Nurse Anesthetist605854NY
3163W00000XRegistered NurseRN2266306MA

General Provider Information

NPI Number : 1659777670
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK BLAZEY MS, CRNA
Provider Business Mailing Address
First Line : 601 ELMWOOD AVE BOX 604
Second Line :
City : ROCHESTER
State : NY
Zip : 14642-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 601 ELMWOOD AVE BOX 604
Second Line :
City : ROCHESTER
State : NY
Zip : 14642-5724
Country : US
Telephone Number : 585-275-1385
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2014
Last Update Date : 02/19/2025

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Directions to “ MARK BLAZEY MS, CRNA” Practice Location

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