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General NPI Number Information
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NPI Number | 1053292870
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Entity Type | Individual
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Provider Name | MS. BLAKE ASHLEY FARNWORTH
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Gender | Female
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 250B ROUTE 25A
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City | SHOREHAM
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State | NY
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Zip | 11786-2106
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Country | US
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Telephone | 631-291-1570
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Fax |
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Provider Business Mailing Address
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Address Line | 23 COMMERCIAL AVE
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City | OAKDALE
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State | NY
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Zip | 11769-1302
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | NY
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