Victoria Carol Clark, M.S. SPECIAL ED

Primary specialty

SpecialistTaxonomy code 174400000X

License

1199846 Issued in NY

Practice address

155 Phillips Hill Rd
New City, NY 10956-4129

Phone

(845) 708-2000

NPI assigned

Jun 29, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jawonio Inc

  • Early Intervention Provider Agency
  • New City, NY
  • NPI 1750726154
  NPD (past)

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1104180546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 SNEDECKER AVE",
            "city": "CONGERS",
            "state": "NY",
            "postal_code": "109201808",
            "telephone_number": "845-268-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 PHILLIPS HILL RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564129",
            "telephone_number": "845-708-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "VICTORIA",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "M.S. SPECIAL ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1199846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicolette Christina Cimino
• Norma Cirlin, LMSW
• Mel Steven Citrin, D.M.D.
• CJS Medical Care P.C.
• Erin Beth Clark, L.AC
• Clarkstown Central School District
• Clarkstown Medical Associates PC
• Clarkstown Medical Care P.C.
• Clarkstown Pharmacy II LLC
• Clarkstown Physical Therapy & Sports Associates, LLP

• Specialist in New City, NY
• Providers in New City, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.