ANDREW THOMAS CLARK (NPI# 1609365352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609365352 |
| Entity Type | Individual |
| Full Name | ANDREW THOMAS CLARK |
| Credential | FNP-BC CCRN |
| Practice Address |
54 New Hyde Park Rd Garden City NY 11530 |
| Mailing Address |
137 Dark Hollow Rd Port Jefferson NY 11777-2047 |
| Practice Telephone | 5164881313 |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2018-07-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
690785 | NY | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
343027 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Belle Terre Rd, Port Jefferson, NY 117771968 | 6314746000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194288563 | Andrew Byler Clark | Student in an Organized Health Care Education/Training Program | 200 Jeanette Lancaster Way, Charlottesville, VA 22903-3388 | 2019-04-11 |
| 1588156509 | Andrew Jeffrey Clark | Chiropractor | 6304 College Blvd, Overland Park, KS 66211-1506 | 2018-06-05 |
| 1518373257 | Andrew Clark | Case Manager/Care Coordinator | 100 Barberry Dr, Knoxville, TN 37912 | 2014-07-02 |
| 1316215528 | Andrew J Clark | Counselor | 1219 Oak Knoll Rd, Santa Maria, CA 93455-4303 | 2011-12-02 |
| 1992017164 | Andrew Edward Clark | Dentist | 1036-42 Dunn Ave, Jacksonville, FL 32218-6359 | 2010-07-05 |
| 1760683635 | Andrew Clark | Student in an Organized Health Care Education/Training Program | 109 Pine Knoll Dr, 347, Ridgeland, MS 39157-1350 | 2007-05-30 |
| 1912988635 | Andrew Robert Clark | Family Medicine | 5123 4th Avenue Cir E, Bradenton, FL 34208-5620 | 2005-11-09 |
| 1093374936 | Andrew Elton Clark | Spec/Tech, Pathology | 6201 Harry Hines Blvd, Dallas, TX 75390-0001 | 2019-06-12 |
| 1679034508 | Andrew Jeffrey Clark | Student in an Organized Health Care Education/Training Program | 530 S Jackson St, Louisville, KY 40202-1675 | 2019-03-25 |
| 1447745336 | Andrew Clark | Student in an Organized Health Care Education/Training Program | 1450 San Pablo St Fl 4, Los Angeles, CA 90033-5331 | 2018-06-25 |
| Street Address |
54 NEW HYDE PARK RD |
| City | GARDEN CITY |
| State | NY |
| Zip Code | 11530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376595215 | Carolyn A. Willis | Dermatology | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-05-17 |
| 1881245876 | Katherine Ann Murphy | Physician Assistant | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2019-09-22 |
| 1306187711 | Eran Sykes | Registered Nurse | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2013-03-09 |
| 1255603817 | Shelley Hannah Fox | Nurse Practitioner | 54 New Hyde Park Rd, Garden City, NY 11530 | 2012-01-29 |
| 1265727333 | Michael Steven Mclemore | Pathology | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2011-06-16 |
| 1366742744 | Renee Drobinski | Physician Assistant | 54 New Hyde Park Rd, Garden City, NY 11530-3948 | 2010-11-01 |
| 1598820698 | Joseph Onorato M.d., P.C. | Specialist | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-12-27 |
| 1942362215 | Kelly Ledermann | Nurse Practitioner | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-12-14 |
| 1013084763 | Dina Marie Puglissi | Specialist | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-11-29 |
| 1992882773 | Joseph Onorato | Dermatology | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144850207 | Ellen Jay Palacio Mabatid | Physical Therapist | 66 New Hyde Park, Garden City, NY 11530 | 2020-01-16 |
| 1255991022 | Rubin Anesthesia Pain Management, Pllc | Anesthesiology | 1103 Stewart Avenue, Suite 300, Garden City, NY 11530 | 2019-06-14 |
| 1144793720 | Jack Doby Garden City, LLC | Eyewear Supplier (Equipment, not the service) | Jack Doby Garden City, LLC, 928 Old Country Road, Garden City, NY 11530 | 2019-01-07 |
| 1386135051 | Granger & Sahasra | Dentist | 1103 Stewart Avenue Suite 104, Garden City, NY 11530 | 2018-05-29 |
| 1598262537 | Suzanne P. Reid-bradshaw | Specialist | Kidz Therapy, 300 Garden City Plaza, Garden City, NY 11530 | 2018-04-06 |
| 1972021129 | Nicole Maria Gaudino | Nurse Practitioner | One South Avenue, Waldo Hall, Garden City, NY 11530 | 2017-09-07 |
| 1619495645 | Christine Scheppa | Registered Nurse | 225 Brompton Rd South, Garden City South, NY 11530 | 2017-08-30 |
| 1699290981 | Deborah Ann Pontosky | Registered Nurse | 104 Fifth Street, Garden City, NY 11530 | 2017-08-08 |
| 1932648748 | Tahmina Jahir | Student in an Organized Health Care Education/Training Program | 15 Hilton Ave, Garden City, NY 11530 | 2017-02-14 |
| 1598209173 | Dino Michelli | Specialist | 300 Garden City Plaza, Ste 350, Kidz Therapy/ Gayle E. Kligman Therapeutic Resources, Garden City, NY 11530 | 2016-12-15 |
| Find all providers in zip 11530 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194345504 | Miriam Anne Dee | Nurse Practitioner | 23 7th St S, Garden City, NY 11530-5522 | 2020-04-26 |
| 1326605429 | Shining Lite Weight Management & Personal Solutions, LLC | Nurse Practitioner | 4483 N Dresden Pl Ste 102, Garden City, ID 83714-5092 | 2019-05-23 |
| 1457879017 | Jami Rae Weaver-warren | Nurse Practitioner | 302 N. Fleming Street Suite 2, Garden City, KS 67846 | 2017-09-05 |
| 1598281826 | Polly Elpers | Nurse Practitioner | 311 E Spruce St Ste 3a, Garden City, KS 67846-5685 | 2017-08-18 |
| 1114469343 | Joyce A Noonan | Nurse Practitioner | 125 15th St, Apt A2, Garden City, NY 11530-1503 | 2016-11-04 |
| 1154798775 | Melanie Howard | Nurse Practitioner | 2613 Governor St, Garden City, GA 31408-2301 | 2015-08-31 |
| 1063845725 | Kristin Rochford | Nurse Practitioner | 600 Old Country Rd Rm 1w, Garden City, NY 11530-2001 | 2013-08-16 |
| 1538504253 | Lisa Anne Savino Fitzgerald | Nurse Practitioner | 174 Brixton Rd, Garden City, NY 11530-1324 | 2013-05-08 |
| 1043248826 | Anita G Hoeme | Nurse Practitioner | 911 N Main Street, Garden City, KS 67846-0500 | 2006-06-29 |
| 1497716476 | Stacey Kay Wright | Nurse Practitioner | 5593 N Glenwood St, Garden City, ID 83714 | 2006-03-30 |
| Find all providers in GARDEN CITY | ||||
| City | GARDEN CITY |
| Zip Code | 11530 |
Please comment or provide details below to improve the information on ANDREW THOMAS CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.