Individual
THOMAS C BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, MSN
Contact information
Practice address
800 HOWARD AVE, YALE PHYSICIANS BLDG, NEW HAVEN, CT 06519-1369
(203) 785-2140
(203) 785-6414
Mailing address
PO BOX 9805, 300 GEORGE ST 6TH FLR, NEW HAVEN, CT 06536-0805
(203) 785-7998
(203) 785-6414
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
003424
CT
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
003424
CT
Other
Enumeration date
04/02/2007
Last updated
09/11/2025
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