Dr. Deidre Blake
Adult Reconstructive Orthopaedic Surgeon
16 Brentwood Dr Suite A
Ithaca
, New York 14850-1863
Dr. Deidre Blake
Adult Reconstructive Orthopaedic Surgeon
16 Brentwood Dr Suite A
Ithaca
, New York 14850-1863
(607) 272-7000
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About
Features
Specialties
- Adult Reconstructive Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Deidre Blake
- 16 Brentwood Dr Suite A
- Ithaca, NY
- Zip : 14850-1863
- Phone : (607) 272-7000
Second Address
- Dr. Deidre Blake
- 16 Brentwood Dr Suite A
- Ithaca, NY
- Zip : 14850-1863
- Phone : (607) 272-7000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 256896 | NY |
National Provider Identifier
| NPI | 1336157015 |
|---|---|
| Provider Name | Dr. Deidre Blake |
| First Address | Ithaca, NY 14850-1863 |
| Second Address | Ithaca, NY 14850-1863 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/08/2006 |
| Last Update Date | 13/09/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.