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General NPI Number Information
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NPI Number | 1073508958
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Entity Type | Individual
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Provider Name | JUDITH S BLACK M.D.,M.H.A.
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Gender | Female
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 4727 FRIENDSHIP AVE STE 200
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City | PITTSBURGH
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State | PA
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Zip | 15224-1778
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Country | US
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Telephone | 412-235-5810
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Fax |
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Provider Business Mailing Address
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Address Line | 352 HUNT RD
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City | PITTSBURGH
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State | PA
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Zip | 15238-2228
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Country | US
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Telephone | 412-963-8401
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD 016868E
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License Number State | PA
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