Blake, Kimberly A

Blake, Kimberly A is an individual health care provider with primary practice located at 106 Calvert St , Harrison NY 10528-3131. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Blake, Kimberly A can be contacted via phone (914) 835-0073.

Contact Information

Primary practice address
106 Calvert St Harrison NY 10528-3131
Phone: (914) 835-0073
Fax: (914) 835-1071
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X F302529 New York

Profile Details

NPI number 1689626319
LBN Legal business name Blake, Kimberly A
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jan 21st, 2020 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1689626319 NPPES
New York Other 0667910001 DME
New York MEDICAID 02073710 DME

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