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1417111493
MICHAEL LAURENCE BLAKE
LAKEWOOD, NJ
NPI
1417111493
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NJ 25MA08599800)
Enumeration Date
2008-07-18
Last Update Date
2011-03-08
Business Address
Dr. MICHAEL LAURENCE BLAKE MD
600 RIVER AVE
LAKEWOOD, NJ 08701-5237
Phone number: 732-942-5721
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Mailing Address
Dr. MICHAEL LAURENCE BLAKE MD
600 RIVER AVE
LAKEWOOD, NJ 08701-5237
Phone number: 732-942-5721
Copy
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