Individual
KATHERINE E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-4141
Mailing address
279 E 44TH ST APT 17H, NEW YORK, NY 10017-4311
(203) 917-7002
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NY
Other
Enumeration date
10/17/2023
Last updated
10/24/2023
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