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Individual

DR. TREVOR EDWARD BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 PARK ST, GLENS FALLS, NY 12801-4413
(518) 926-1942
(518) 926-1943
Mailing address
100 PARK ST, GLENS FALLS, NY 12801-4413
(518) 926-1942
(518) 926-1943

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
266458
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
62581
ALBANY MEDICAL CENTER IDENTIFICATION NUMBER
NY
Enumeration date
11/05/2008
Last updated
11/01/2012
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