| Doctor Name: | JUAN C. BLAS-BORIA |
| NPI Number: | 1205881018 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD418251 |
| Business Practice Address: | Fourth And Walnut Streets Radiology Department Lebanon, PA - 170421281 |
| Business Phone Number: | 7172707642 |
| Business Fax Number: | 7172727069 |
| Mailing Address: | 1001 Briggs Rd, Suite 210 MOUNT LAUREL |
| State: | NJ |
| Postal Code: | 080544100 |
| Phone Number: | 8562314774 |
| Fax Number: | 8562319699 |
| NPI Enumeration Date: | 05/23/2006 |
| NPI Last Update Date: | 10/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | MD418251 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |