Black, Stephanie

Black, Stephanie is an individual health care provider with primary practice located at 34Th Street & Civic Center Blvd Suite 9329, Philadelphia PA 19104-4399. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Anesthesiology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Anesthesiology is her primary health care specialty. Black, Stephanie can be contacted via phone (215) 590-1858.

Contact Information

Primary practice address
34Th Street & Civic Center Blvd Suite 9329 Philadelphia PA 19104-4399
Fax: (215) 590-1415
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Anesthesiology 207LP3000X MD443506 Pennsylvania
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MT191494 Pennsylvania

Profile Details

NPI number 1710184908
LBN Legal business name Black, Stephanie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2007
Last updated Jan 30th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710184908 NPPES
Pennsylvania Other 254874EJL MEDICARE PTAN
Pennsylvania MEDICAID 1027597410001 MEDICARE PTAN

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