National Provider Identifier

Andrew S Black, DPM, PA

Andrew S Black, DPM, PA is listed in the NPPES registry with a primary specialty of Podiatrist in Horseheads, NY and a listed phone number of (607) 795-1666.

NPI 1073552105Horseheads, NYPodiatrist

Profile Overview

NPI
1073552105
Provider Type
Individual
Primary Specialty
Podiatrist
Enumeration Date
June 05, 2006
Last Updated
November 20, 2020

Practice Location

  • 100 John Roemmelt Dr Ste 102
  • Horseheads, NY 14845-8302

Phone: (607) 795-1666

Mailing Address

  • 571 Saint Josephs Blvd
  • Fl 2
  • Elmira, NY 14901-3230

Specialties

  • Podiatrist (213E00000X)
  • Foot Surgery Podiatrist (213ES0131X)
Full Record
NPI
1073552105
Entity Type
Individual
Last Name
Black
First Name
Andrew
Middle Name
S
Name Prefix
Dr.
Credential
DPM, PA
Mailing Street Address
571 Saint Josephs Blvd
Mailing Address Line 2
Fl 2
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-3230
Mailing Country
US
Mailing Phone
(607) 271-2050
Mailing Fax
(607) 271-2099
Practice Street Address
100 John Roemmelt Dr Ste 102
Practice City
Horseheads
Practice State
NY
Practice ZIP Code
14845-8302
Practice Country
US
Practice Phone
(607) 795-1666
Practice Fax
(607) 796-0839
Enumeration Date
June 05, 2006
Last Updated
November 20, 2020
Sex
Male
Sole Proprietor
No
Certification Date
November 20, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Podiatrist (213E00000X), Foot Surgery Podiatrist (213ES0131X)
Other Identifiers
04308852 (NY), 103755030 (PA)