Individual
GIAN LOUIS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5676 RIVERDALE AVE, BRONX, NY 10471-2138
(718) 796-5300
(718) 884-2901
Mailing address
5676 RIVERDALE AVE, BRONX, NY 10471-2138
(718) 796-5300
(718) 884-2901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
00000000
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174557409
—
NY
Enumeration date
10/06/2025
Last updated
10/06/2025
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