Michael Laurence Blake MD

NPI 1417111493 - Internal Medicine - 207R00000X

NPI Details
NPI 1417111493
Gender Male
Enumeration Date 07/18/2008
Last Updated 03/08/2011
Entity Type Individual
Active Over 8 years ago
Practice Location
600 RIVER AVE
LAKEWOOD NJ, 08701-5237, US
Phone (732) 942-5721
Fax (732) 942-5723
Business Location
600 RIVER AVE
LAKEWOOD NJ, 08701-5237, US
Phone (732) 942-5721
Fax (732) 942-5723
Toxanomy
Taxonomy Code 207R00000X
License State New Jersey
License Number 25MA08599800
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According to our database, Dr. Michael Laurence Blake MD NPI is 1417111493, taxonomy code is 207R00000X and license number is 25MA08599800, license state is located at New Jersey. Michael Laurence Blake MD physically located at 600 River Ave, Lakewood NJ, 08701-5237. NPI Number Michael Laurence Blake MD has the Individual type.

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1417111493 NPI number is provided on an as is basis without warranty of any kind. 1417111493 is maintained by the National Plan & Provider Enumeration System. The contents of Michael Laurence Blake MD are for informational purposes only.