Individual
MS. ELIZABETH THORNDIKE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0002
(585) 275-2530
Mailing address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0002
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
348216
NY
363LF0000X
Family Nurse Practitioner
Primary
348216
NY
Other
Enumeration date
08/24/2021
Last updated
07/17/2023
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