Provider Demographics
NPI:1174525695
Name:BLAKESLEE, DON B (MD)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:B
Last Name:BLAKESLEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:900 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996-1109
Mailing Address - Country:US
Mailing Address - Phone:845-476-4738
Mailing Address - Fax:845-938-1132
Practice Address - Street 1:900 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996-1109
Practice Address - Country:US
Practice Address - Phone:845-476-4738
Practice Address - Fax:845-938-1134
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0024895207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF06500Medicare UPIN