Individual
DR. ANDREW THOMAS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC, DNP
Contact information
Practice address
1270 AVENUE OF THE AMERICAS STE 757, NEW YORK, NY 10020-1700
(646) 248-7651
Mailing address
137 DARK HOLLOW RD, PORT JEFFERSON, NY 11777-2047
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
690785
NY
363LF0000X
Family Nurse Practitioner
Primary
343027
NY
Other
Enumeration date
05/08/2018
Last updated
02/10/2023
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