Individual
BLAKE ELIZABETH VESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 ALLEN RD, BASKING RIDGE, NJ 07920-2976
(908) 616-1383
Mailing address
140 ALLEN RD, BASKING RIDGE, NJ 07920-2976
(908) 616-1383
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA11750900
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2019
Last updated
06/11/2023
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