National Provider Identifier
Robert Demarest Blake Jr.
Robert Demarest Blake Jr. is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Fillmore, NY and a listed phone number of (214) 223-1567.
Profile Overview
- NPI
- 1285029389
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- April 06, 2015
- Last Updated
- April 06, 2015
Practice Location
- 11242 Mills Mills RD
- Fillmore, NY 14735-8622
Phone: (214) 223-1567
Specialties
- Licensed Practical Nurse (164W00000X)
- Adult Care Home Facility (311ZA0620X)
Full Record
- NPI
- 1285029389
- Entity Type
- Individual
- Last Name
- Blake
- First Name
- Robert
- Middle Name
- Demarest
- Name Suffix
- Jr.
- Mailing Street Address
- 11242 Mills Mills RD
- Mailing City
- Fillmore
- Mailing State
- NY
- Mailing ZIP Code
- 14735-8622
- Mailing Country
- US
- Mailing Phone
- (214) 223-1567
- Practice Street Address
- 11242 Mills Mills RD
- Practice City
- Fillmore
- Practice State
- NY
- Practice ZIP Code
- 14735-8622
- Practice Country
- US
- Practice Phone
- (214) 223-1567
- Enumeration Date
- April 06, 2015
- Last Updated
- April 06, 2015
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X), Adult Care Home Facility (311ZA0620X)