Provider Demographics
NPI:1144042458
Name:BLANC, EUGENE T
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:T
Last Name:BLANC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 SUMNER ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1654
Mailing Address - Country:US
Mailing Address - Phone:216-276-0047
Mailing Address - Fax:
Practice Address - Street 1:608 SUMNER ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1654
Practice Address - Country:US
Practice Address - Phone:216-276-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide