Black, Trevor Edward
Black, Trevor Edward is an individual health care provider with primary practice located at 100 Park St , Glens Falls NY 12801-4413. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Black, Trevor Edward can be contacted via phone (518) 926-1942.Contact Information
Primary practice address
100 Park St
Glens Falls NY 12801-4413
Phone: (518) 926-1942
Fax: (518) 926-1943
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 266458 | New York |
Profile Details
| NPI number | 1780838631 |
|---|---|
| LBN Legal business name | Black, Trevor Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 5th, 2008 |
| Last updated | Nov 1st, 2012 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780838631 | NPPES |
| New York | Other | 62581 | ALBANY MEDICAL CENTER IDENTIFICATION NUMBER |
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