Aaliyah Jordan Black, PA-C is a
Physician Assistant based in Hebron, Connecticut. Aaliyah Jordan Black is licensed to practice in * (Not Available) (license number ) and her current practice location is
21 Liberty Dr, Hebron, Connecticut. She can be reached at her office (for appointments etc.) via phone at
(860) 228-9300.
NPI number for Aaliyah Jordan Black is 1205677291 and her current mailing address is 41 Massabesic Dr, Auburn, New Hampshire. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1205677291.
Provider's Profile
| Full Name | Aaliyah Jordan Black |
|---|
| Gender | Female |
|---|
| Speciality | Physician Assistant |
|---|
| Location | 21 Liberty Dr, Hebron, Connecticut |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1205677291
- Provider Enumeration Date: 06/04/2024
- Last Update Date: 07/02/2026
Medical Identifiers
Medical identifiers for Aaliyah Jordan Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205677291 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Aaliyah Jordan Black is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Aaliyah Jordan Black, PA-C
41 Massabesic Dr,
Auburn, NH 03032-3167
Ph: (860) 228-9300 | Aaliyah Jordan Black, PA-C
21 Liberty Dr,
Hebron, CT 06248
Ph: (860) 228-9300 |
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