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
Phone: (551) 996-4450
Fax: (551) 996-5729
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | P1979 | Texas |
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 25MA10947800 | New Jersey |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1487807145 | NPPES |
Texas | MEDICAID | 080462703 |
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