Individual
MS. ANNIE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. A., P. T.
Contact information
Practice address
10850 71ST AVE, SUITE LL 1, FOREST HILLS, NY 11375-4564
(718) 268-6072
(718) 268-0226
Mailing address
10850 71ST AVE, SUITE LL 1, FOREST HILLS, NY 11375-4564
(718) 268-6072
(718) 268-0226
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6044
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P376499
OXFORD
—
Enumeration date
07/29/2005
Last updated
04/23/2012
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