Individual
KRISTOPHER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 YOUNGS RD STE 100, WILLIAMSVILLE, NY 14221-2698
(716) 961-9900
(716) 961-9911
Mailing address
1020 YOUNGS RD STE 100, WILLIAMSVILLE, NY 14221-2698
(716) 961-9900
(716) 961-9911
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
320529
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
320529
NEW YORK STATE OFFICE OF PROFESSIONS
NY
Enumeration date
03/22/2016
Last updated
11/06/2023
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