Individual
SAMANTHA K BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
825 WEHRLE DR, WILLIAMSVILLE, NY 14221
(716) 634-3243
(716) 634-6056
Mailing address
3719 UNION RD STE 218, CHEEKTOWAGA, NY 14225-4251
(716) 206-1503
(716) 651-9945
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10001929A
IN
Other
Enumeration date
08/11/2015
Last updated
07/24/2019
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