# CLARK PINSON, PHD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043618499
- **Authorized official:** DR. CLARK DANIEL PINSON PH.D. (PSYCHOLOGIST)
- **Authorized official phone:** (315) 514-0401

## Contact information

- **Practice address:** 114 N LOWELL AVE, SYRACUSE, NY 13204-2014
- **Practice address phone:** (315) 514-0401
- **Mailing address:** 114 N LOWELL AVE, SYRACUSE, NY 13204-2014
- **Mailing address phone:** (315) 514-0401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 020187 | NY | — |
| 302R00000X | Health Maintenance Organization | 020187 | NY | Yes |
| 305R00000X | Preferred Provider Organization | 020187 | NY | — |
| 305S00000X | Point of Service | 020187 | NY | — |

## Other

- **Enumeration date:** 12/17/2014
- **Last updated:** 12/17/2014