27 LEWIS LN, SYOSSET, 11791, NEW YORK
| Entity Name | JERRY G. BLAIVAS, M.D., P.C. |
| Entity Number | 863642 |
| Status | ACTIVE |
| Incorporation Date | 24th August 1983 |
| Dos Process Address | 445 EAST 77TH STREET, NEW YORK, 10075, NEW YORK |
| Jurisdiction | NEW YORK |
| County | NEW YORK |
| Legal form | DOMESTIC PROFESSIONAL CORPORATION |