Clark, Susan M
Clark, Susan M is an individual health care provider with primary practice located at 1318 S Main Road , Vineland NJ 08360. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Clark, Susan M can be contacted via phone (856) 691-8585.Contact Information
Primary practice address
1318 S Main Road
Vineland NJ 08360
Phone: (856) 691-8585
Fax: (856) 691-8489
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 26NN08675900 | New Jersey |
Profile Details
| NPI number | 1609968692 |
|---|---|
| LBN Legal business name | Clark, Susan M |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Dec 28th, 2011 - about 14 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 | 1609968692 | NPPES |
| New Jersey | MEDICAID | 7201206 |
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