Healthcare Provider Details

I. General information

NPI: 1225969793
Provider Name (Legal Business Name): PATRICIA SARA BLAZON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 PLEASANT VIEW TER
WALLINGTON NJ
07057-2016
US

IV. Provider business mailing address

25 PLEASANT VIEW TER
WALLINGTON NJ
07057-2016
US

V. Phone/Fax

Practice location:
  • Phone: 201-705-4330
  • Fax:
Mailing address:
  • Phone: 201-705-4330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: