NPIMap

Organization Active NPI

Robert H Clark MD PLLC

  • Specialist
  • Wantagh, NY
National Provider Identifier
1700825692
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
144682 Issued in NY
Legal business name
ROBERT H CLARK MD PLLC
Practice address
1259 Wantagh Ave
Wantagh, NY 11793-2205
Phone
(516) 221-7971
Fax
(516) 221-8117
NPI assigned
Jun 6, 2006
Last updated
Apr 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Dr. Robert Henry Clark, MDNPI 1932106408
Title
Owner
Phone
(516) 221-7971

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 144682 NY Primary

Addresses

Primary practice location

1259 Wantagh Ave
Wantagh, NY 11793-2205

Mailing address

1259 Wantagh Ave
Wantagh, NY 11793-2205
Phone (516) 221-7971

Other names 1

  • Robert H. Clark M.D. P.L.L.C. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1700825692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932205",
            "telephone_number": "516-221-7971",
            "fax_number": "516-804-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932205",
            "telephone_number": "516-221-7971",
            "fax_number": "516-221-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT H CLARK MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-221-7971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "144682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert H. Clark M.D. P.L.L.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.