DR. Diane R Blake, M.D.
NPI #1316921182 in Worcester, Massachusetts
Provider Information
- NPI Number
- 1316921182
- Entity Type
- Individual
- Name
- DR. Diane R Blake, M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Pediatrics - Adolescent Medicine
- Credential
- M.D.
- Enumeration Date
- Dec 5, 2005
- Last Updated
- Nov 10, 2020
Practice Location
- Address
- 55 LAKE AVE N
- Address 2
- DEPARTMENT OF ADOLESCENT MEDICINE
- City
- Worcester
- State
- Massachusetts
- ZIP Code
- 01655-0002
- Phone
- (508) 856-5624
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics - Adolescent Medicine — Adolescent Medicine |
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