Individual
SARDIA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCT
Contact information
Practice address
55 SHERIDAN AVE, MOUNT VERNON, NY 10552-2541
(914) 704-7505
Mailing address
630 GRAMATAN AVE APT GRM2, MOUNT VERNON, NY 10552-1830
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
X3Z3C7D4
NY
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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