National Provider Identifier Database

KELSO L BLAZE
Physician Assistant

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.


Contact Information

KELSO L BLAZE
2530 N HOWARD ST UNIT 2
PHILADELPHIA, PA19133
Phone: 732-744-4962
Fax:
Website:
Specialty Taxonomy Code
* Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for KELSO L BLAZE

NPI Number 1255096707
Credentials
Entity Individual
Enumeration date 11/01/2021
Last updated 11/01/2021 - About 5 years ago
Sole proprietor1 Yes
Identifiers
  • PA Medicaid: 5306693119
Hospital affiliation n/a

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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