Provider Demographics
NPI:1437273406
Name:BLAKELEY, ANN KATHLEEN (DO)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:KATHLEEN
Last Name:BLAKELEY
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:5011 WILLOW CREEK CT
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-6117
Mailing Address - Country:US
Mailing Address - Phone:724-625-6416
Mailing Address - Fax:724-625-6319
Practice Address - Street 1:20826 ROUTE 19
Practice Address - Street 2:CRANBERRY MEDICAL ARTS BLDG II
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-6028
Practice Address - Country:US
Practice Address - Phone:724-625-6440
Practice Address - Fax:724-625-6319
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2010-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS005174L202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
459411RG9Medicare ID - Type Unspecified
B42025Medicare UPIN