Christine A Clark, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

180733 Issued in NY

Practice address

11 Evelyn CT
Manorville, NY 11949-2851

Phone

(631) 801-3188

NPI assigned

Oct 19, 2012

Last updated

Oct 19, 2012By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1144573783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EVELYN CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492851",
            "telephone_number": "631-801-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 EVELYN CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492851",
            "telephone_number": "631-801-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTINE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "180733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa Louise Catalanohanson, OTR
• Ka Lun Benny Chan, RPH
• Fang Chen, MD
• Sanjeev Chopra, P.T.
• Mary Cirko, LMT
• Kathryn Hamma Clavin-Vunkannon, LMSW, LCSW, CASAC
• Constance Cleary, RN
• Linda A Cohen, M.S., C.C.C.
• Mikayla Coleman
• Randi L Connelly, OTRL

• Licensed Practical Nurse in Manorville, NY
• Providers in Manorville, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.