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Individual

LINDA LEVITA CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D., M.S.

Contact information

Practice address
301 EXCHANGE BLVD, SUITE LL-1, ROCHESTER, NY 14608-2755
(585) 227-0072
(585) 227-9585
Mailing address
237 RED HICKORY DR, ROCHESTER, NY 14626-4018
(585) 720-9053
(585) 227-9585

Taxonomy

Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
194302
NY
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
200001097
NC
2083P0901X
Public Health & General Preventive Medicine Physician
194302
NY
2083P0901X
Public Health & General Preventive Medicine Physician
200001097
NC
2083X0100X
Occupational Medicine Physician
Primary
194302
NY
2083X0100X
Occupational Medicine Physician
200001097
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
121959GJ
PREFERRED CARE
NY
01
194302
EXCELLUS ROCHESTER REGION
NY
01
7413612
AETNA
NY
Enumeration date
06/18/2008
Last updated
05/25/2021
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