Clark, Kristen

Clark, Kristen is an individual health care provider with primary practice located at 985 Cedar Bridge Ave , Brick NJ 08723-4167. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Clark, Kristen can be contacted via phone (732) 477-5600.

Contact Information

Primary practice address
985 Cedar Bridge Ave Brick NJ 08723-4167
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MA09430200 New Jersey

Profile Details

NPI number 1447559455
LBN Legal business name Clark, Kristen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2011
Last updated Feb 26th, 2015 - about 10 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 1447559455 NPPES
New Jersey MEDICAID 0429694

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