Clark Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA04400000 Issued in NJ

Legal business name

CLARK PEDIATRICS, LLC

Practice address

480 Oak Ridge Rd
Clark, NJ 07066-2124

Phone

(732) 574-9444

NPI assigned

Oct 8, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dulce Suapengco Samonte, M.D.NPI 1356417075

Title

Owner

Phone

(732) 574-9444

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dulce Suapengco Samonte, MD

  • Pediatrics Physician
  • Clark, NJ
  • NPI 1356417075
  NPD (past) Authorized official
• Maya Nisani, PT, DPT

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1336854272
  NPD (past)
• Catherine Marie Samonte, M.D.

  • Pediatrics Physician
  • Clark, NJ
  • NPI 1538459771
  NPD (past)
• Sarah Y Kwon, PA-C

  • Physician Assistant
  • Valley Stream, NY
  • NPI 1407617129
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1093186702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 OAK RIDGE RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070662124",
            "telephone_number": "732-574-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 OAK RIDGE RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070662124",
            "telephone_number": "732-574-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "SAMONTE",
        "authorized_official_first_name": "DULCE",
        "authorized_official_middle_name": "SUAPENGCO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-574-9444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA04400000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Board of Education
• Clark Dermatology LLC
• Clark Diagnostics LLC
• Clark Nursing and Rehabilitation Center LLC
• Clark Nursing and Rehabilitation Center, LLC
• Clark Psychology Center
• Clark Rehab Services LLC
• Clark Volunteer Emergency Squad Inc
• CMLC ABA, LLC
• Emily Rebecca Cohen, DPT

• Pediatrics Physician in Clark, NJ
• Providers in Clark, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.