Individual
GREGORY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-5503
Mailing address
317 E 73RD ST APT 5FE, NEW YORK, NY 10021-0152
(484) 252-9309
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
312756-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/07/2019
Last updated
06/09/2025
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