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Individual

DR. BLAKE ALLISTER LE GRAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
325 S HIGHLAND AVE STE 106, BRIARCLIFF MANOR, NY 10510-2054
(914) 366-0015
(914) 366-0012
Mailing address
38 1/2 WOLDEN RD APT C2-8, OSSINING, NY 10562-5312
(347) 992-0736

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA11081300
NJ
208000000X
Pediatrics Physician
Primary
308910
NY

Other

Enumeration date
04/09/2018
Last updated
09/26/2024
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