101 FOREST PARK DRIVE, WOODHAVEN, 11421-1051, NEW YORK
| Entity Name | EDISON R. BLANCO, PHYSICIAN, P.C. |
| Entity Number | 2249328 |
| Status | ACTIVE |
| Incorporation Date | 14th April 1998 |
| Dos Process Address | 16 BRENTWOOD RD, BAY SHORE, 11706-8011, NEW YORK |
| Jurisdiction | NEW YORK |
| County | SUFFOLK |
| Legal form | DOMESTIC PROFESSIONAL CORPORATION |