Individual
ELWYN C CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
70 DUBOIS ST, NEWBURGH, NY 12550-4851
(845) 561-4400
Mailing address
206 MONTGOMERY ST, NEWBURGH, NY 12550-3639
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
247501
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
247501-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247501
LICENSE
NY
Enumeration date
06/23/2008
Last updated
06/19/2012
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