Blake, Dwayne
Blake, Dwayne is an sole proprietor health care provider with primary practice located at 372 Jericho Tpke , Floral Park NY 11001-2235. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Blake, Dwayne can be contacted via phone (516) 326-3811.Contact Information
Primary practice address
372 Jericho Tpke
Floral Park NY 11001-2235
Phone: (516) 326-3811
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 348517 | New York |
Profile Details
| NPI number | 1194480335 |
|---|---|
| LBN Legal business name | Blake, Dwayne |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 2nd, 2021 |
| Last updated | Dec 27th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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