Individual
PHILIP BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, PA-C
Contact information
Practice address
2 RIVERVIEW DR, DANBURY, CT 06810-6268
(203) 797-1500
Mailing address
2 RIVERVIEW DR, DANBURY, CT 06810-6268
(203) 797-1500
(203) 702-6695
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4359
CT
Other
Enumeration date
11/19/2018
Last updated
08/19/2024
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