Individual ProviderGenevieve BlaizeLicensed Practical NurseNursing Service ProvidersPractice Address19 Florence Ct, Patchogue, NY 11772-4262(631) 289-0291PECOS EnrollmentBased on the most recent information from CMS, provider Genevieve Blaize does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1275828014Provider TypeIndividualFull NameBlaize, GenevieveCredentialLPNGenderFemaleSole ProprietorNoEnumeration Date6/9/2011Last Updated6/9/2011Contact InformationPractice LocationPractice Address19 Florence Ct, Patchogue, NY 11772-4262Phone(631) 289-0291FaxUnlisted FaxMailing LocationMailing Address19 Florence Ct, Patchogue, NY 11772-4262Phone(631) 289-0291FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense243202New York