Provider Demographics
NPI:1598976995
Name:BLACK, MARGARET B (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:B
Last Name:BLACK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:WARETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08758-1743
Mailing Address - Country:US
Mailing Address - Phone:609-756-5028
Mailing Address - Fax:732-756-0660
Practice Address - Street 1:501 ROUTE 9
Practice Address - Street 2:
Practice Address - City:WARETOWN
Practice Address - State:NJ
Practice Address - Zip Code:08758-1743
Practice Address - Country:US
Practice Address - Phone:609-756-5028
Practice Address - Fax:732-756-0660
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO05928000363LA2200X
NJ26NN05928000163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience