DR. PERRY BLACK (NPI# 1083750103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083750103 |
| Entity Type | Individual |
| Full Name | DR. PERRY BLACK |
| Credential | M.D. |
| Practice Address |
219 N Broad St Fl -10th Philadelphia PA 19107-1519 |
| Mailing Address |
219 N. Broard St.- 10th Fl. Philadelphia PA 19107-1192 |
| Practice Telephone | 2157624157 |
| Practice Fax Number | 2157626275 |
| Mailing Telephone | 2157624157 |
| Mailing Fax Number | 2157626275 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
MD022449E | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | NJ MEDICAL ASSIST. | 2518201 | 01 |
| PA | DEA # | AB8798552 | 01 |
| PA | HEALTH PARTNERS | 12768 | 01 |
| PA | AETNA | 1967 | 01 |
| PA | 2518201 | 05 | |
| PA | BS OF PA | 082101 | 01 |
| PA | KEYSTONE HEALTH PLAN EAST | 52215000 | 01 |
| PA | OXFORD | P717671 | 01 |
| PA | HMA | PE94502 | 01 |
| PA | HEALTH NET | 2Y5003 | 01 |
| PA | PA. MEDICAL ASSIST. | 0733162 | 01 |
| PA | KEYSTONE MERCY | 32154A | 01 |
| PA | MD # | MD022449E | 01 |
| Street Address |
219 N BROAD ST FL -10TH |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-1519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154839553 | American Access Care of Sp LLC | Clinic/Center | 2412 W Passyunk Ave # 14, Philadelphia, PA 19145-4114 | 2018-01-19 |
| 1265950802 | M&m Surgical Center PC | Clinic/Center | 1 Crescent Dr. Suite 300, Philadelphia, PA 19112 | 2017-09-05 |
| 1154787117 | The Pennsylvania Surgery and Laser Center LLC | Clinic/Center | 601 Franklin Mills Cir, Philadelphia, PA 19154-3124 | 2016-01-06 |
| 1023347226 | The Children's Hospital of Philadelphia | Clinic/Center | 34th & Civic Center Ave, Philadelphia, PA 19104 | 2009-12-17 |
| 1710114293 | Riverview Surgery Center At The Navy Yard Lp | Clinic/Center | Three Crescent Drive, Navy Yard Corporate Center, Philadelphia, PA 19112 | 2009-06-11 |
| 1447301122 | Planned Parenthood Southeastern Pennsylvania | Clinic/Center | 1144 Locust St, Philadelphia, PA 19107-6734 | 2007-01-16 |
| 1679658710 | Stadium Campus Ambulatory Surgical Center, LLC | Clinic/Center | 3340 S Broad St, Philadelphia, PA 19145-5802 | 2006-10-26 |
| 1215038252 | Red Lion Surgicenter, LLC | Clinic/Center | 240 Geiger Rd, Philadelphia, PA 19115-1008 | 2006-09-25 |
| 1447218433 | Liberty Eye Surgical Center LLC | Clinic/Center | 9122 Blue Grass Rd, Philadelphia, PA 19114-3202 | 2006-05-02 |
| 1386646891 | Temple University of The Commonwealth System of Higher Education | Clinic/Center | 8th At Race Street, Second Floor, Philadelphia, PW 19107-0000 | 2005-08-15 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
Please comment or provide details below to improve the information on DR. PERRY BLACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.