Gabrielle M Clark

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

569650 Issued in NY

Practice address

600 Franklin St Ste 204
Schenectady, NY 12305-2107

Phone

(518) 372-7031

Fax

(518) 372-7064

NPI assigned

Jun 5, 2024

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

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.

• Conifer Park, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Liverpool, NY
  • NPI 1366498768
  NPD (past)

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1215778998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 IVY AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041426",
            "telephone_number": "518-225-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FRANKLIN ST STE 204",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123052107",
            "telephone_number": "518-372-7031",
            "fax_number": "518-372-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GABRIELLE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "569650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Schenectady
• Claim Path New York, LLC
• Cecilia Frazier Clair, FNP,RN,MS
• Patrick Clancy
• Amanda Lynn Clark, LPN
• Kristina Inez Clark
• Kristina M Clark, NP
• Lori A Clark, RN
• Sarah E Clarke, RPA
• Colleen Clausson

• Registered Nurse in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.