MS. Diane M Blake

NPI #1144581976 in Rocky Point, New York

Provider Information

NPI Number: 1144581976
Entity Type: Individual
Name: MS. Diane M Blake
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Jun 7, 2012
Last Updated: Jun 7, 2012

Practice Location

Address: 1 COMUS RD
City: Rocky Point
State: New York
ZIP Code: 11778-9541
Phone: (631) 821-3746

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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