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Contact Information

DEIDRE BLAKE, MD
16 BRENTWOOD DR
SUITE A
ITHACA, NY14850-1863
 Phone: 607-272-7000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adult Reconstructive Orthopaedic Surgery

207XS0114X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for DEIDRE BLAKE · (Female)

NPI # 1336157015
Status Active
Credentials MD
Entity Individual
Enumeration date 08/04/2006
Last updated 09/13/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 256896
Hospital affiliation(s)
  • CAYUGA MEDICAL CENTER AT ITHACA - (Acute Care)
    101 DATES DRIVE
    ITHACA, NY 14850
  • CORTLAND REGIONAL MEDICAL CENTER INC - (Acute Care)
    134 HOMER AVENUE
    CORTLAND, NY 13045
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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