Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nids Coalition Northern Chapter

Organization General Practice Physician · NPI 1114178001

Nids Coalition Northern Chapter is a General Practice Physician in Black River, New York. Registered with an NPI since 2008.

In the registry since
2008

Practice location Address checks out

103 S Main St
Black River, NY 13612-2101
Phone: (315) 773-5405
Fax: (315) 773-5378
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1114178001
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Katherine Robertson — Director · (315) 773-5405
NPI enumeratedOctober 9, 2008
Last updated in NPPESOctober 9, 2008
Mailing address103 S Main St, Black River, NY 13612-2101