Individual
DR. DEBRA ELLEN BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
558 LARKFIELD RD, EAST NORTHPORT, NY 11731-4204
(631) 486-7459
Mailing address
46 NORTHGATE CRES, MELVILLE, NY 11747-3028
(516) 822-9109
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
179846
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03848208
—
NY
Enumeration date
12/05/2006
Last updated
02/24/2026
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