Elyse E Clark, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

001283-1 Issued in NY

Practice address

4400 Vestal Parkway
Binghamton University Events Center
Binghamton, NY 13902-6000

Phone

(607) 777-2784

Fax

(607) 777-5577

NPI assigned

Feb 20, 2007

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.

• Binghamton University

  • Primary Care Clinic/Center
  • Binghamton, NY
  • NPI 1558901173
  NPD (past)
• Binghamton University Health Services

  • Student Health Clinic/Center
  • Binghamton, NY
  • NPI 1568679520
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245375252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N PAGE AVE",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137603936",
            "telephone_number": "607-239-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 VESTAL PARKWAY",
            "address_2": "BINGHAMTON UNIVERSITY EVENTS CENTER",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139026000",
            "telephone_number": "607-777-2784",
            "fax_number": "607-777-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELYSE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "001283-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawneicia Renee Ciulla, LPN
• Sandra A Ciullo, RPA-C
• Katelyn Clare, LMSW
• Deborah D Clarhaut, CRNA
• Catherine Clark
• Lisa Ann Clark, LMT
• Takisha Clark
• Maelynn Clarke, LCSW
• Justin Cleveland
• Kati Jo Cline, CASACII, BA

• Athletic Trainer in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.