Individual
ROBERT TYLER BLAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U6641458203
CIGNA
CA
Enumeration date
11/29/2022
Last updated
06/01/2026
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