Individual
COURTNEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
620 COLUMBUS AVE STE 2, NEW YORK, NY 10024-1459
(212) 600-9411
Mailing address
660 WHITE PLAINS RD FL ENTA4, TARRYTOWN, NY 10591-5139
(914) 984-2552
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
033995
NY
Other
Enumeration date
07/31/2025
Last updated
08/04/2025
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