Individual
MR. MARVIN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1034 E 233RD ST STE 2, BRONX, NY 10466-3317
(347) 913-4373
(914) 462-4513
Mailing address
463 E TREMONT AVE, FL 2, BRONX, NY 10457-4301
(646) 399-3668
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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