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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TRACI BLAKE, PA

Active

TRACI BLAKE, PA is a Physician Assistant healthcare provider located in ENGLEWOOD, New Jersey. NPI 1922519271 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · ENGLEWOOD, NJ

Registration Details

NPI Number
1922519271
Provider Type
Individual
Gender
Female
NPI Issued
Oct 13, 2017 (8.8204533916253 yrs)
Last Updated
Jul 18, 2022
Licenses
021388 (NY)
25MP00449500 (NJ)

Practice Information

Address
401 S VAN BRUNT ST STE 3
ENGLEWOOD, NJ, 076314600
Browse NJ providers · Browse ZIP 07631
Phone
2015692770
Fax
2015691774
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in ENGLEWOOD, NJ

Name Credential NPI
JULIA A ELIZONDO PA 1295771335
EDWIN SALAMANCA PA 1134165269
JUMS I BABATUNDE P.A. 1710027586
PARTHENA KALLOPOULOS PHYSICIAN ASSISTANT 1902948375
MS. HEATHER MARIE MOHRMAN P.A.-C 1548480452
MR. BARRY S HUGHES PA 1841405123
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.