Organization
CLARK PINSON, PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARK DANIEL PINSON PH.D. (PSYCHOLOGIST)
(315) 514-0401
Entity
Organization
Contact information
Practice address
114 N LOWELL AVE, SYRACUSE, NY 13204-2014
(315) 514-0401
Mailing address
114 N LOWELL AVE, SYRACUSE, NY 13204-2014
(315) 514-0401
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
020187
NY
302R00000X
Health Maintenance Organization
Primary
020187
NY
305R00000X
Preferred Provider Organization
020187
NY
305S00000X
Point of Service
020187
NY
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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