SearchNew York106H00000X

Douglass Clark, M.DIV

NPI 1386470789 · on the registry since 2024 · sole proprietor

Practice

Address
1559 County Route 5
Canaan, NY 12029
Phone
(917) 968-2493

Registry record

Primary taxonomy
106H00000X
106H00000X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-09-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York