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General NPI Number Information
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NPI Number | 1023036548
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Entity Type | Individual
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Provider Name | ROBERT GARY BLAKE MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 333 ROEBLING ST
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City | BROOKLYN
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State | NY
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Zip | 11211-6204
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Country | US
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Telephone | 718-218-6414
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Fax | 718-240-0411
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Provider Business Mailing Address
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Address Line | 591 HANCOCK ST
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City | BROOKLYN
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State | NY
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Zip | 11233-6584
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Country | US
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Telephone | 917-279-3308
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 213092-1
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License Number State | NY
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