Individual
SHARON A BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 SEYMOUR AVE, 3, NEWARK, NJ 07108
(201) 285-9709
Mailing address
8 LOMBARDY ST, SUITE342, NEWARK, NJ 07102
(201) 285-9709
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
0451157670
NJ
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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