National Provider Identifier
Deidre Blake, M.D.
Deidre Blake, M.D. is listed in the NPPES registry with a primary specialty of Adult Reconstructive Orthopaedic Surgery Physician in Ithaca, NY and a listed phone number of (607) 272-7000.
Profile Overview
- NPI
- 1336157015
- Provider Type
- Individual
- Primary Specialty
- Adult Reconstructive Orthopaedic Surgery Physician
- Enumeration Date
- August 04, 2006
- Last Updated
- September 13, 2016
Practice Location
- 16 Brentwood Dr
- Suite A
- Ithaca, NY 14850-1863
Phone: (607) 272-7000
Specialties
- Adult Reconstructive Orthopaedic Surgery Physician (207XS0114X)
Full Record
- NPI
- 1336157015
- Entity Type
- Individual
- Last Name
- Blake
- First Name
- Deidre
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 16 Brentwood Dr
- Mailing Address Line 2
- Suite A
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1863
- Mailing Country
- US
- Mailing Phone
- (607) 272-7000
- Practice Street Address
- 16 Brentwood Dr
- Practice Address Line 2
- Suite A
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1863
- Practice Country
- US
- Practice Phone
- (607) 272-7000
- Enumeration Date
- August 04, 2006
- Last Updated
- September 13, 2016
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Adult Reconstructive Orthopaedic Surgery Physician (207XS0114X)