Clark, Richard

Clark, Richard is an individual health care provider with primary practice located at 181 N Belle Mead Rd , East Setauket NY 11733-3495. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Clark, Richard can be contacted via phone (631) 444-4200.

Contact Information

Primary practice address
181 N Belle Mead Rd East Setauket NY 11733-3495
Phone: (631) 444-4200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 181488 New York

Profile Details

NPI number 1700825429
LBN Legal business name Clark, Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Dec 6th, 2013 - 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 1700825429 NPPES
New York MEDICAID 01175460

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