Individual
COLLEEN ROSE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
385 TREMONT AVE, EAST ORANGE, NJ 07018-1023
(973) 676-1000
Mailing address
39 BOSWORTH ST, STATEN ISLAND, NY 10310-2809
(718) 737-8927
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/31/2025
Last updated
07/31/2025
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