Mr. Dwayne Blake, NP
Nurse Practitioner, Family in Floral Park, New York
1194480335- Practice location
- 31 Covert Ave # 1030, Floral Park, NY 11001-3216
- Phone
- 516-402-0194
- Fax
- 516-232-9534
- Last updated
- July 1, 2025
Dwayne Blake is a Nurse Practitioner, Family based in Floral Park, NY. Dwayne Blake practices in Floral Park, NY and has the professional credentials of NP. The NPI Number for Dwayne Blake is 1194480335 and holds a License No. 407104 (NY). The current practice location address for Dwayne Blake is 31 Covert Ave # 1030, Floral Park, NY 11001-3216 and can be reached out via phone at 516-402-0194 and via fax at 516-232-9534.
Provider Profile Details
- NPI Number
- 1194480335
- Provider Name
- Dwayne Blake
- Credential
- NP
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 31 Covert Ave # 1030, Floral Park, NY 11001-3216
- Phone Number
- 516-402-0194
- Fax Number
- 516-232-9534
- Primary Taxonomy
- Nurse Practitioner, Family · 363LF0000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- November 2, 2021
- Last Update Date
- July 1, 2025
- Certification Date
- July 1, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 31 Covert Ave # 1030
Floral Park, NY 11001-3216 - City
- Floral Park
- State
- New York
- Zip
- 11001-3216
- Phone Number
- 516-402-0194
- Fax Number
- 516-232-9534
Provider Business Mailing Address Details
- Address
- 31 Covert Ave # 1030
Floral Park, NY 11001-3216 - City
- Floral Park
- State
- NY
- Zip
- 11001-3216
- Phone Number
- 516-402-0194
- Fax Number
- 518-933-2531
License Information
- License Number (1)
- 407104
- License State (1)
- NY
- Taxonomy (1)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- License Number (2)
- 348517
- License State (2)
- NY
- Taxonomy (2)
- Nurse Practitioner, Family · 363LF0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mr. Dwayne Blake, NP?
The NPI number of Mr. Dwayne Blake, NP is 1194480335. It was assigned on November 2, 2021 and is currently active in the NPPES registry.
What is the specialty of Mr. Dwayne Blake, NP?
Mr. Dwayne Blake, NP is registered under the primary taxonomy Nurse Practitioner, Family (code 363LF0000X), licensed in NY under license number 407104.
Where does Mr. Dwayne Blake, NP practice?
The practice location is 31 Covert Ave # 1030, Floral Park, NY 11001-3216. The office can be reached at 516-402-0194 (phone) or 516-232-9534 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1194480335 directly on the NPPES registry website.