Active NPI
Harvey E Black, MD
- Family Medicine Physician
- Cicero, NY
National Provider Identifier
1093817082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 149425
- Practice address
- 5813 East Seymour St
Cicero, NY 13039 - Phone
- (315) 699-2789
- Fax
- (315) 699-6251
- NPI assigned
- Sep 1, 2006
- Last updated
- Dec 1, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 149425 | NY | Primary |
Addresses
Primary practice location
5813 East Seymour St
Cicero, NY 13039
Mailing address
5813 East Seymour St
Cicero, NY 13039
Phone (315) 699-2789
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149425 | NY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291161600000",
"number": "1093817082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5813 EAST SEYMOUR ST",
"city": "CICERO",
"state": "NY",
"postal_code": "13039",
"telephone_number": "315-699-2789",
"fax_number": "315-699-6251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5813 EAST SEYMOUR ST",
"city": "CICERO",
"state": "NY",
"postal_code": "13039",
"telephone_number": "315-699-2789",
"fax_number": "315-699-6251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "HARVEY",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2010-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "149425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cicero, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.