Authorities released this image in 2019 of Dr. George Blatti writing a prescription in his car.

A Rockville Centre-based doctor who ignored repeated warnings not to prescribe excessive amounts of painkillers to his drug-dependent patients has been charged with murder after five of those patients died of overdoses.

Dr. George Blatti was charged with five counts of depraved indifference murder and 11 counts of reckless endangerment. Authorities said it’s the first time a doctor has been charged in New York State with murder for depraved indifference.

“Basically he’s a serial killer, in our opinion,” Nassau County District Attorney Madeline Singas told reporters Wednesday during a news conference outside of her office in Mineola. Calling it the worst case of reckless endangerment she’s seen in 30 years as a prosecutor, she added: “His prescription pad was as lethal as any murder weapon.”

Singas said the 75-year-old doctor ignored repeated warnings from insurance companies, pharmacies, an oversight agency, victim’s families, and at least three patients themselves that he was over-prescribing addictive painkillers. In one case, he allegedly prescribed nine times the recommended dosage of painkillers. And in other instances, he wrote prescriptions for patients in his car without performing an exam, according to investigators.

Addition prescription painkillers such as OxyContin have fueled the opioid epidemic that has ravaged Long Island for more than a decade amid the deadliest drug crisis in American history. The crisis has seen a resurgence since the coronavirus pandemic disrupted treatment for those in recovery and caused others whose lives were upended to start using.

The fatal overdose victims were a a 31-year-old man from Floral Park, a 44-year-old Valley Stream man, a 53-year-old Port Washington woman, a 50-year-old woman, and a 55-year-old man. Doses ranged from prescribed more than 1,000 painkillers in five months to more than 18,000 pills in four years.

The doctor’s arrest is the result of a 3 1/2 year joint investigation involving the Nassau County police and the U.S. Drug Enforcement Administration. A Nassau County grand jury previously indicted Dr. Blatti on a slew of charges related to diverting prescriptions in 2019. He pleaded not guilty in that case and was arraigned on the new charges Thursday.

Dr. Blatti was ordered held without bail on the new charges and is due back in court on March 30. He faces up to 25 years to life in prison, if convicted. His attorney was not immediately available to comment.

The charges come a week after a former New York City police officer pleaded guilty to manslaughter for selling the fentanyl that caused a fatal overdose in Copiague as a part of a drug-trafficking ring the ex-cop helped run.

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