Individual
CARA KAY BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-5540
Mailing address
2554 PERRY HWY, CLARKS MILLS, PA 16114-2320
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
0173491
NY
282N00000X
General Acute Care Hospital
Primary
0173491
NY
282N00000X
General Acute Care Hospital
OCO11922
PA
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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