Clark, Alan B.

Clark, Alan B. is an individual health care provider with primary practice located at 240 Central Ave , East Orange NJ 07018-3313. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Clark, Alan B. can be contacted via phone (973) 674-3500.

Contact Information

Primary practice address
240 Central Ave East Orange NJ 07018-3313
Phone: (973) 674-3500
Fax: (973) 678-6319
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X MA20681 New Jersey

Profile Details

NPI number 1366500712
LBN Legal business name Clark, Alan B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Aug 9th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366500712 NPPES
New Jersey Other 280330501 MEDICAID GROUP
New Jersey MEDICAID 5069505 MEDICAID GROUP
New Jersey Other 135853 MEDICAID GROUP

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