Organization
SWIFTTEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALIZA BLACK PA (PHYSICIAN ASSISTANT)
(917) 776-8725
Entity
Organization
Contact information
Practice address
78 FRANKLIN ST, ENGLEWOOD, NJ 07631-3616
(917) 776-8725
Mailing address
78 FRANKLIN ST, ENGLEWOOD, NJ 07631-3616
(917) 776-8725
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12345
—
NJ
Enumeration date
04/22/2021
Last updated
04/22/2021
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