Individual
MRS. KENISHA R BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5 E 98TH ST FL 7, NEW YORK, NY 10029-6501
(917) 701-2064
Mailing address
4075 SETON AVE, BRONX, NY 10466-2332
(917) 701-2064
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306760-1
NY
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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