Clark, Richard
Clark, Richard is an individual health care provider with primary practice located at 181 N Belle Mead Rd , East Setauket NY 11733-3495. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Clark, Richard can be contacted via phone (631) 444-4200.Contact Information
Primary practice address
181 N Belle Mead Rd
East Setauket NY 11733-3495
Phone: (631) 444-4200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 181488 | New York |
Profile Details
| NPI number | 1700825429 |
|---|---|
| LBN Legal business name | Clark, Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Dec 6th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700825429 | NPPES |
| New York | MEDICAID | 01175460 |
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