Blake, Timothy Daniel

Blake, Timothy Daniel is an individual health care provider with primary practice located at 5 Coliseum Ave , Nashua NH 03063-3292. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Blake, Timothy Daniel can be contacted via phone (603) 882-9800.

Contact Information

Primary practice address
5 Coliseum Ave Nashua NH 03063-3292
Phone: (603) 882-9800
Fax: (603) 882-0556
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 230010 Massachusetts
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 12643 New Hampshire

Profile Details

NPI number 1891790986
LBN Legal business name Blake, Timothy Daniel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Apr 4th, 2023 - about 3 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 1891790986 NPPES
New Hampshire MEDICAID 3072166

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