A Long Island doctor has been charged with second-degree murder in the deaths of five of his patients who overdosed.

Dr. George Blatti is accused of causing the death by over-prescribing opioids.

Prosecutors believe this is the first time a doctor in New York state is charged with murder in the second degree with depraved indifference to human life.

Blatti, 75, walked into court in Mineola to be formally charged with five counts of second-degree murder and 11 counts of reckless endangerment.

Prosecutors say this is in addition to a 54-count indictment the former doctor is facing following his 2019 arrest, when he was initially accused of illegally selling prescription medication.

Nassau District Attorney Madeline Singas says he sold thousands of pills out of a makeshift office at what was a RadioShack in Franklin Square, and even out of his car in parking lots of the Rockville Centre hotel near where he lived.

Nassau police, the DA's Office and the Drug Enforcement Administration worked together on the investigation.

"They were extremely dangerous in combinations that were prescribed," says Bryan Iula, of the DEA. "This is basic knowledge for anyone who holds a DEA registration, a pharmacist, a mid-level practitioner or an MD."

Singas says his victims were far too young to die and his prescription pad was as lethal as a murder weapon.

"Most importantly, and tragically, at least three of his patients asked him to stop prescribing opioids to themselves, and sought help from their addictions," says Singas.

Blatti pleaded not guilty to the new charges, and the judge ordered him to be held without bail. If convicted, Blatti faces 25 years to life in prison.

Prosecutors say Blatti voluntarily surrendered his medical license when he was first arrested in 2019. He's due back in court at the end of the month.