Doctor Name: | MRS. CAROLINE DELCETA BLACK |
NPI Number: | 1346460698 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 17660 |
Business Practice Address: | National Naval Medical Center Rockville Pike Bethesda, MD - 20850 |
Business Phone Number: | 3012954880 |
Business Fax Number: | |
Mailing Address: | 11411 Brook Run Dr, GERMANTOWN |
State: | MD |
Postal Code: | 208766021 |
Phone Number: | 3015401886 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | 17660 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |