Provider Demographics
NPI:1285828970
Name:BLAKES, KARLA ANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:ANNETTE
Last Name:BLAKES
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Gender:F
Credentials:MD
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Mailing Address - Street 1:225 FROEHLICH FARM BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2922
Mailing Address - Country:US
Mailing Address - Phone:516-364-5400
Mailing Address - Fax:516-677-3656
Practice Address - Street 1:225 FROEHLICH FARM BLVD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2922
Practice Address - Country:US
Practice Address - Phone:516-364-5400
Practice Address - Fax:516-677-3656
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2011-10-05
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Provider Licenses
StateLicense IDTaxonomies
NY251595207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology