Blake, Dwayne

Blake, Dwayne is an sole proprietor health care provider with primary practice located at 31 Covert Ave # 1030 , Floral Park NY 11001-3216. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Blake, Dwayne can be contacted via phone (516) 402-0194.

Contact Information

Primary practice address
31 Covert Ave # 1030 Floral Park NY 11001-3216
Phone: (516) 402-0194
Fax: (516) 232-9534
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 407104 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 348517 New York

Profile Details

NPI number 1194480335
LBN Legal business name Blake, Dwayne
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2021
Last updated Jul 1st, 2025 - about last year

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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