Black, Jill Diane
Black, Jill Diane is an individual health care provider with primary practice located at 701 Savannah Rd A-1, Lewes DE 19958-1550. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Black, Jill Diane can be contacted via phone (302) 644-2530.Contact Information
Primary practice address
701 Savannah Rd A-1
Lewes DE 19958-1550
Phone: (302) 644-2530
Fax: (302) 644-2556
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | J10000513 | Delaware |
Profile Details
| NPI number | 1184818601 |
|---|---|
| LBN Legal business name | Black, Jill Diane |
| Credentials | PT, DPT, EDD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 28th, 2007 |
| Last updated | Jul 3rd, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184818601 | NPPES |
| Delaware | MEDICAID | 1184818601 |
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