KRISTINA M CLARK (NPI# 1679836605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679836605 |
| Entity Type | Individual |
| Full Name | KRISTINA M CLARK |
| Credential | NP |
| Practice Address |
700 Mcclellan St Schenectady NY 12304-1019 |
| Mailing Address |
711 Troy Schenectady Rd Ste 203 Latham NY 12110-2461 |
| Practice Telephone | 5183725637 |
| Practice Fax Number | 5183721384 |
| Mailing Telephone | 5187823700 |
| Mailing Fax Number | 5187823799 |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2018-01-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 501366 | NY | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
382310 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03494502 | 05 | |
| NY | FIDELIS CARE NY | 120919000071 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063871341 | Kristina Clark | Registered Nurse | 1631 Nw Saint Lucie West Blvd Ste 208, Port Saint Lucie, FL 34986-1963 | 2016-02-16 |
| 1932733037 | Kristina Clark | Student in an Organized Health Care Education/Training Program | 3600 Route 112, Coram, NY 11727-4116 | 2020-02-27 |
| 1083173702 | Kristina M Clark | Counselor | 3375 Us Route 60, Huntington, WV 25705-2837 | 2019-03-13 |
| 1598140147 | Kristina Clark | Nurse Practitioner | 625 19th St S, Jt 807, Birmingham, AL 35249-6810 | 2015-07-24 |
| 1487905451 | Kristina Inez Clark | Speech-Language Pathologist | 1270 Belmont Ave, Schenectady, NY 12308-2104 | 2012-09-30 |
| 1164706586 | Kristina Kehoskie Clark | Physical Therapist | 117 Bennoch Rd, Orono, ME 04473-3620 | 2011-10-04 |
| 1689858755 | Kristina Clark | Counselor | 3408 Andover St, Oakland, CA 94609-2817 | 2007-12-24 |
| 1114058906 | Kristina L Clark | Registered Nurse | 2045 Franklin St, Denver, CO 80205-5437 | 2007-03-07 |
| Street Address |
700 MCCLELLAN ST |
| City | SCHENECTADY |
| State | NY |
| Zip Code | 12304-1019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932166295 | Scott J Pickett | Podiatrist | 700 Mcclellan St, Suite 203, Schenectady, NY 12304-1019 | 2006-04-28 |
| 1780060350 | Susan A Kessler, Md, Pllc | Ophthalmology | 700 Mcclellan St, Suite 102, Schenectady, NY 12304-1019 | 2015-08-06 |
| 1073995064 | Tristin Cadle | Nurse Practitioner | 700 Mcclellan St, Schenectady, NY 12304-1019 | 2015-06-25 |
| 1093138208 | Leonard F Combi | Specialist | 700 Mcclellan St, Suite 104, Schenectady, NY 12304-1019 | 2014-01-23 |
| 1407289077 | Upstate Podiatry Services | Durable Medical Equipment & Medical Supplies | 700 Mcclellan St, Suite 203, Schenectady, NY 12304-1019 | 2013-08-18 |
| 1770823973 | Schenectady Ent Pllc | Otolaryngology | 700 Mcclellan St, Schenectady, NY 12304-1019 | 2013-02-25 |
| 1033470141 | Susan A Kessler Md | Ophthalmology | 700 Mcclellan St, Suite 102, Schenectady, NY 12304-1019 | 2012-06-05 |
| 1952501793 | Susan Smith Woods | Psychologist | 700 Mcclellan St, Schenectady, NY 12304-1019 | 2007-07-19 |
| 1942339486 | Philip Anthony Fraterrigo | Ophthalmology | 700 Mcclellan St, St. Clare's Medical Arts Building, Schenectady, NY 12304-1019 | 2007-03-02 |
| 1144359613 | Philip Fraterrigo | Ophthalmology | 700 Mcclellan St, St. Clare's Medical Arts Building, Schenectady, NY 12304-1019 | 2007-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780173682 | Aminah Alia Roberts | Registered Nurse | 200 Hillcrestave, Schenectady, NY 12304 | 2018-05-07 |
| 1871046870 | Katie Tonkin | Dentist | 445 Balltown Rd Ste 2, Schenectady, NY 12304 | 2016-07-27 |
| 1508226655 | Karen Verret | Specialist | 230 Oregon Ave, Schenectady, NY 12304 | 2016-03-02 |
| 1104161850 | Northeast Parent and Child Society | Local Education Agency (LEA) | 327 Abbottsford Road, Schenectady, NY 12304 | 2012-12-06 |
| 1316207061 | Amanda C Fennicks | Licensed Practical Nurse | 1743 Hamburg St, Schenectady, NY 12304 | 2012-05-29 |
| 1639445232 | Lisa Marie Langer | Pharmacist | 2037 State Street, Schenectady, NY 12304 | 2012-03-28 |
| 1487922167 | Mary Ellen B Nagel | Registered Nurse | 1821 Hamburg St, Schenectady, NY 12304 | 2011-12-08 |
| 1699084624 | Paula Frances Williams | Speech-Language Pathologist | 2566 Balltown Road, Schenectady, NY 12304 | 2010-09-24 |
| 1558547133 | Fraterrigo Eye Physicians &surgeons, Pllc | Ophthalmology | 700 Mcclellan Street, St. Clare's Medical Arts Building, Schenectady, NY 12304 | 2008-01-14 |
| 1104022730 | William T. Tirone | Dentist | 600 Mcclellan Street, Schenectady, NY 12304 | 2007-06-21 |
| Find all providers in zip 12304 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265955819 | Misty D Thomas | Nurse Practitioner | 1044 State St, Schenectady, NY 12307-1508 | 2017-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709821 | Shu-heng Wang | Nurse Practitioner | 7324 18th Ave, Brooklyn, NY 11204-5678 | 2020-10-29 |
| 1952909012 | Marina Byshovets | Nurse Practitioner | 164 Admiralty Loop, Staten Island, NY 10309-3964 | 2020-10-12 |
| 1700483799 | Dmitry Pediatrics, Pediatric Nurse Practitioner PC | Nurse Practitioner | 10 Shore Blvd Apt 1g, Brooklyn, NY 11235-4022 | 2020-10-03 |
| 1427664572 | Leigh Ann Cohen | Nurse Practitioner | 2 Lincoln Ave Ste 301, Rockville Centre, NY 11570-5775 | 2020-09-23 |
| 1295341436 | Tatiana Margaret Masone | Nurse Practitioner | 3142 Victory Blvd, Staten Island, NY 10314-6717 | 2020-09-22 |
| 1992311567 | Jyneva W Pickel | Nurse Practitioner | 3959 Broadway Rm 722, New York, NY 10032-1559 | 2020-09-19 |
| 1902410186 | Katie Elise Boyd | Nurse Practitioner | 725 Irving Ave Ste 504, Syracuse, NY 13210-1683 | 2020-09-03 |
| 1437763877 | Tiffany Yu | Nurse Practitioner | 1746 W 12th St, Brooklyn, NY 11223-1101 | 2020-09-02 |
| 1134733710 | Khristan Heagle Haller | Nurse Practitioner | 20 Locust Ln, Bronxville, NY 10708-4933 | 2020-09-01 |
| 1831703412 | Marijana Waite | Nurse Practitioner | 6544 Saunders St Apt A7, Rego Park, NY 11374-4209 | 2020-09-01 |
| Find all providers with the same taxonomy | ||||
| City | SCHENECTADY |
| Zip Code | 12304 |
Please comment or provide details below to improve the information on KRISTINA M 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.