IndividualActive
Diane Blake, M.D.
NPI 1316921182 · Pediatric Adolescent Medicine Physician · Worcester, MA
Provider details
- NPI number
- 1316921182
- Entity type
- Individual
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 154470 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
55 Lake Ave N
Department of Adolescent Medicine
Worcester, MA 01655-0002
Phone: (508) 856-5624
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 62
Shrewsbury, MA 01545-0062
Registry dates
- Enumerated
- 2005-12-05
- Last updated
- 2020-11-10
- Certified
- 2020-11-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.