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NPI Code Detail

MEDICARE: GERARD BLANCO

MEDICARE: GERARD BLANCO
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
1225X00000XOccupational TherapistOT-3339NV

General Provider Information

NPI Number : 1942064092
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERARD BLANCO
Provider Business Mailing Address
First Line : 5351 MONTESSOURI ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1126
Country : US
Telephone Number : 702-251-2200
Fax Number :
Provider Business Practice Location Address
First Line : 5351 MONTESSOURI ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1126
Country : US
Telephone Number : 702-251-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2024
Last Update Date : 02/09/2024

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Directions to “ GERARD BLANCO ” Practice Location

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