Individual
ELANA T CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
74 PASCACK RD, PARK RIDGE, NJ 07656
(201) 326-7120
Mailing address
74 PASCACK RD, PARK RIDGE, NJ 07656-1935
(201) 326-7120
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA10092600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2014
Last updated
11/20/2019
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