Individual
DR. VIVIAN L CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3909
(607) 547-6325
Mailing address
PO BOX 725, COOPERSTOWN, NY 13326-0725
(607) 547-3909
(607) 547-6325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
233275
NY
207RC0000X
Cardiovascular Disease Physician
Primary
233275
NY
207RI0011X
Interventional Cardiology Physician
233275
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02588067
—
NY
Enumeration date
04/25/2006
Last updated
09/11/2025
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