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Individual

ELIZABETH MORRIGAN CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3400 BAINBRIDGE AVE, BRONX, NY 10467-2404
(866) 633-8255
(718) 655-9672
Mailing address
115 E 87TH ST, APT. 15E, NEW YORK, NY 10128-1136
(866) 633-8255
(718) 655-9672

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
171055
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01019956
NY
Enumeration date
11/01/2006
Last updated
11/19/2013
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