Clark, Patricia A
Clark, Patricia A is an individual health care provider with primary practice located at 3640 Main St Suite 205, Springfield MA 01107-1145. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Clark, Patricia A can be contacted via phone (413) 739-7367.Contact Information
Primary practice address
3640 Main St Suite 205
Springfield MA 01107-1145
Phone: (413) 739-7367
Fax: (413) 737-2686
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 002619 | Connecticut |
Profile Details
| NPI number | 1134194269 |
|---|---|
| LBN Legal business name | Clark, Patricia A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Jan 7th, 2011 - 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 | 1134194269 | NPPES |
| Connecticut | MEDICAID | 004236396 |
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