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Contact Information

LARRY BLACKMORE, PA
121 DEKALB AVE
BROOKLYN, NY11201-5425
 Phone: 718-250-8444
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chronic Disease Hospital

281P00000X
Indicates primary specialty

NPI Profile & details for LARRY BLACKMORE · (Male)

NPI Number 1427296227
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 02/02/2009
Last updated 02/02/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 007277
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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