Clark Medical Care, P.L.L.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CLARK MEDICAL CARE, P.L.L.C.

Practice address

400 Webster Ave
New Rochelle, NY 10801-3206

Phone

(914) 400-1919

Fax

(914) 357-2020

NPI assigned

Mar 2, 2020

Organization subpart

No

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

Authorized official

Name

Charlotte Maria-Carlotta Clark, MDNPI 1891920682

Title

Owner

Phone

(718) 362-1411

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charlotte M Clark, M.D.

  • Internal Medicine Physician
  • New Rochelle, NY
  • NPI 1891920682

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1952935702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CORPORATE WAY STE 2M",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892027",
            "telephone_number": "718-362-1411",
            "fax_number": "718-414-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WEBSTER AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108013206",
            "telephone_number": "914-400-1919",
            "fax_number": "914-357-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK MEDICAL CARE, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "MARIA-CARLOTTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-362-1411",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincenzo Antonio Cirillo, MD
• City School District of New Rochelle
• City School District of New Rochelle
• City School District of New Rochelle
• Stephanie Clapes
• Charlotte M Clark, M.D.
• Sonya Clark
• Claude Errington Williams, DPM, P.C.
• Deborah Anne Clelland, MPS
• Dominique Clery

• Internal Medicine Physician in New Rochelle, NY
• Providers in New Rochelle, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.