Robert H Clark MD PLLC

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

Organization subpart

No

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

Authorized official

Name

Dr. Robert Henry Clark, MD

Title

Owner

Phone

(516) 221-7971

Specialties & licenses 1

Addresses

Other names 1

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

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"
        }
    ]
}

• John Paul Rincon, MS PT
• Lisa Marie Ripi-Hanemann, DIPL.AC, LAC, LMT
• Alyssa Risdon, MHC-LP
• Richard T Risko, DO
• Carmen Ivette Rivera, LCSW
• Robert S Gross MD, PC
• Maureen Elizabeth Roche, M.A
• Linda Iris Rodriguez-Herman, MS CCC SLP
• Casey Rolla
• Kerri L Roloson, LPN

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

• 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.