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
Phone: (732) 477-5600
Fax:
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1447559455 | NPPES |
New Jersey | MEDICAID | 0429694 |
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