Individual
MEGAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
331 SPRINGFIELD AVE, SUMMIT, NJ 07901-3626
(908) 777-8782
Mailing address
25 MARJALEEN DR, RANDOLPH, NJ 07869-3411
(201) 741-3881
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG12220001
NJ
Other
Enumeration date
01/20/2023
Last updated
04/13/2026
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