Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Luis A Blanco, PAC

Individual provider Medical Physician Assistant · NPI 1043532179

Mr. Luis A Blanco, PAC is a Medical Physician Assistant in Corona, New York. Licensed in New York. Registered with an NPI since 2010.

Licensed in
NY
In the registry since
2010
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

10211 Roosevelt Ave
Corona, NY 11368-2331
Phone: (718) 898-1386
Fax: (718) 898-1093
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 005075-1 (NY)

Record details

NPI number1043532179
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedFebruary 16, 2010
Last updated in NPPESApril 19, 2018
Mailing address25 Jackson Ave, White Plains, NY 10606-2216

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