Clark, Sharonda Nicole

Clark, Sharonda Nicole is an individual health care provider with primary practice located at 30 Prospect Ave , Hackensack NJ 07601-1915. She recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as her primary health care specialty. Clark, Sharonda Nicole can be contacted via phone (551) 996-4450.

Contact Information

Primary practice address
30 Prospect Ave Hackensack NJ 07601-1915
Fax: (551) 996-5729
Website:

Health care specialties

Profile Details

NPI number 1487807145
LBN Legal business name Clark, Sharonda Nicole
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2008
Last updated Dec 8th, 2020 - about 5 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 1487807145 NPPES
Texas MEDICAID 080462703

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