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NPI Code Detail

MEDICARE: PAIGE D BLACK

MEDICARE: PAIGE D BLACK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse184221OH

General Provider Information

NPI Number : 1528917325
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE D BLACK
Provider Business Mailing Address
First Line : 1317 ROUTE 73 STE 200
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-2202
Country : US
Telephone Number : 856-439-6111
Fax Number :
Provider Business Practice Location Address
First Line : 7400 HUNTINGTON PARK DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-5617
Country : US
Telephone Number : 614-505-0377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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Directions to “ PAIGE D BLACK ” Practice Location

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