| | Physician Last Name: | Blake |
| | Physician First Name: | Nancy |
| | Physician Middle Name: | C. |
| | Address: | Address redacted |
| | License Number: | 223034 |
| | License Type: | MD |
| | Year of Birth: |
1962
|
| | Effective Date: | 09/11/2018 |
| | Action Description for DOH Webpage: | Indefinite suspension for no less than twelve months during which the physician is precluded from reliance upon her New York State medical license to exempt her from the license requirements set forth in statute or regulation for the practice of any other profession licensed, regulated or certified by the New York State Board of Regents, New York State Department of Education, New York State Department of Health or the New York State Department of State. Upon compliance with the conditions of this order, the physician may apply for a modification order staying the indefinite suspension of her New York State medical license. Upon the determination that the physician is found to be fit to resume the practice of medicine she will be placed on probation for a period of no less than five years and may be subject to any additional terms and conditions deemed necessary. |
| | Misconduct Description for DOH Webpage: | The physician did not contest the charges of having committed professional misconduct by practicing the profession of medicine with negligence on more than one occasion and failing to maintain accurate patient medical records. |
| | License Limitations or Conditions for DOH Webpage: | During the period of probation the physician may only practice medicine when her practice is being supervised by a licensed physician board certified in an appropriate specialty and when she is being monitored by qualified health care professionals. |
| | Board Order: |
|
