person
Dr. Debra Ellen Blaine, MD
General Practice Physician in East Northport, New York
NPI 1841358140

Debra Ellen Blaine is a General Practice Physician based in Melville, NY. Debra Ellen Blaine practices in East Northport, NY and has the professional credentials of MD. The NPI Number for Debra Ellen Blaine is 1841358140 and holds a License No. 179846 (New York).

The current practice location address for Debra Ellen Blaine is 1912 E Jericho Trpk, East Northport, NY and can be reached out via phone at 631-238-3065 and via fax at 631-443-4625.

Location: 1912 E Jericho Trpk, East Northport, NY, 11747-3028
person
Provider Profile Details
NPI Number
1841358140
Provider Name
Debra Ellen Blaine
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
1912 E Jericho Trpk, East Northport, NY, 11747-3028
Phone Number
631-238-3065
Fax Number
631-443-4625
Provider Enumeration Date
12/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
03848208 05 NY
institution
Provider Business Practice Location Address Details
Address
1912 E Jericho Trpk
City
State
Zip
11731-1173
Phone Number
631-238-3065
Fax Number
631-443-4625
person
Provider Business Mailing Address Details
Address
1912 E Jericho Trpk
City
State
Zip
11731-1173
Phone Number
631-238-3065
Fax Number
631-443-4625
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
179846 (New York)
Definition
Definition to come...
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