MEDICARE: JUAN C. BLAS-BORIA M.D.

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
1	2085U0001X	Diagnostic Ultrasound Physician	MD418251	PA
2	2085B0100X	Body Imaging Physician	MD418251	PA
3	2085R0202X	Diagnostic Radiology Physician	MD418251	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205881018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN C. BLAS-BORIA M.D.

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	252 S 4TH ST
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-6111
Country	:	US
Telephone Number	:	717-270-7732
Fax Number	:	717-270-7639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	02/05/2026

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