ROGER CLARK (NPI# 1922640721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922640721 |
| Entity Type | Individual |
| Full Name | ROGER CLARK |
| Practice Address |
160 Convent Ave Harris Hall H-15 New York NY 10031-9198 |
| Mailing Address |
2040 Gleason Ave Apt 2k Bronx NY 10472-5282 |
| Practice Telephone | 2126507745 |
| Mailing Telephone | 6469390733 |
| Enumeration Date | 2019-10-13 |
| Last Update Date | 2019-10-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | NY | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104476225 | Roger Kevin Clark Jr. | Pharmacist | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2019-09-19 |
| 1225458136 | Roger Clark | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2014-04-17 |
| 1205166238 | Roger Clark | Pharmacist | 19003 N R H Johnson Blvd, Sun City West, AZ 85375-4402 | 2010-01-14 |
| 1992976542 | Roger Dale Clark | Hearing Instrument Specialist | 4300 W Waco Dr, A2, Waco, TX 76710-7010 | 2008-03-21 |
| 1821202383 | Roger E Clark | Dentist | 736 Columbus Ave, Lebanon, OH 45036-1608 | 2007-05-10 |
| 1669501136 | Roger Galen Clark | Psychologist | Blanchfield Army Community Hospital, 650 Joel Dr, Fort Campbell, KY 42223-5349 | 2007-03-02 |
| 1235181140 | Roger P. Clark | Internal Medicine | 1153 Centre St, Suite 4955, Boston, MA 02130-3446 | 2006-05-17 |
| Street Address |
160 CONVENT AVE HARRIS HALL H-15 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10031-9198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235193921 | Louis Leonard Cregler | Internal Medicine | 160 Convent Ave, Suite H-301, New York, NY 10031-9101 | 2006-04-12 |
| 1427684117 | Joseph Kennedy | Student in an Organized Health Care Education/Training Program | 160 Convent Ave, New York, NY 10031-9198 | 2020-03-13 |
| 1912543182 | Crystal Findlay | Student in an Organized Health Care Education/Training Program | 160 Convent Ave, New York, NY 10031-9101 | 2019-11-22 |
| 1578107546 | Rezve Karim | Student in an Organized Health Care Education/Training Program | 160 Convent Ave, New York, NY 10031-9101 | 2019-11-04 |
| 1124662002 | Cesia Noelia Rosamilia | Student in an Organized Health Care Education/Training Program | 160 Convent Ave, New York, NY 10031-9101 | 2019-11-04 |
| 1407490378 | Ashwag Mokbel | Student in an Organized Health Care Education/Training Program | 160 Convent Ave, New York, NY 10031-9101 | 2019-11-04 |
| 1821632894 | Christine Olivier | Student in an Organized Health Care Education/Training Program | 160 Convent Ave, New York, NY 10031-9101 | 2019-11-03 |
| 1174167134 | Ana Lorena Pisera | Student in an Organized Health Care Education/Training Program | 160 Convent Ave, New York, NY 10031-9198 | 2019-11-03 |
| 1891339859 | Tooba Anwar | Student in an Organized Health Care Education/Training Program | 160 Convent Ave, New York, NY 10031-9101 | 2019-11-03 |
| 1528602588 | Estefania Lazo | Student in an Organized Health Care Education/Training Program | 160 Convent Ave, New York, NY 10031-9101 | 2019-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883675 | Lisa Tian Chen | Physician Assistant | 160 Convent Ave., Harris Hall #15, New York, NY 10031 | 2019-10-18 |
| 1699329144 | Dianna Rosario | Registered Nurse | 640 Riverside Drive, New York, NY 10031 | 2019-08-01 |
| 1447767058 | Sophie Jetta Miller | Social Worker | 507 West 140th Street, #43, New York, NY 10031 | 2018-01-04 |
| 1376074005 | Broadway Rx Enterprises Inc | Pharmacy | 3489 Broadway, New York, NY 10031 | 2017-03-24 |
| 1174061469 | Mbene Diop | In Home Supportive Care | 505 West 148 St Apt 4a, New York, NY 10031 | 2017-02-07 |
| 1447702691 | Sylvan Roger Maginley Jr. | General Practice | 302 Convent Avenue 6, New York, NY 10031 | 2016-11-03 |
| 1477009124 | Anthony Mcfadden | Counselor | 625 West 140th Street, Manhattan, NY 10031 | 2016-08-31 |
| 1942754601 | E-green Pharmacy Inc | Pharmacy | 3500 Broadway, New York, NY 10031 | 2016-08-11 |
| 1356712657 | Sandra Bulos | Internal Medicine | 3410-18 Broadway 2nd Fl, New York, NY 10031 | 2015-10-13 |
| 1033591375 | Phillip Carron | Family Medicine | 3556 Broadway, New York, NY 10031 | 2015-06-23 |
| Find all providers in zip 10031 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881671 | Celeste Finelli | Student in an Organized Health Care Education/Training Program | 255 W 36th St Rm 201, New York, NY 10018-7700 | 2020-11-06 |
| 1407457310 | Omri Sulimani | Student in an Organized Health Care Education/Training Program | 1425 Madison Ave Ste L4-60, New York, NY 10029-6514 | 2020-11-06 |
| 1215537931 | Gloria Helena Gomez Arenas | Student in an Organized Health Care Education/Training Program | 220 East 57th Street, Apt 5c, New York, NY 10022 | 2020-10-30 |
| 1033719216 | Vanessa Tee-ting Ng | Student in an Organized Health Care Education/Training Program | 1 Park Avenue, Nyu Langone Child Study Center, 7th Floor, New York, NY 10016 | 2020-10-28 |
| 1457959652 | Marwan Nihad Abdel Rauf Yusuf | Student in an Organized Health Care Education/Training Program | Metropolitan Hospital Center Department of Medicine, 1901, 1 St Avenue, New York, NY 10029 | 2020-10-12 |
| 1558968537 | Yiyang Zhang | Student in an Organized Health Care Education/Training Program | 1000 10th Ave Fl 2, New York, NY 10019-1147 | 2020-10-03 |
| 1699372706 | Anna Jane Dare | Student in an Organized Health Care Education/Training Program | 1275 York Avenue Department of Surgery, Memorial Sloan, Kettering Cancer Center, New York, NY 10065 | 2020-10-02 |
| 1285241018 | Grace A Forrester | Student in an Organized Health Care Education/Training Program | 517 W 121st St Apt 604s, New York, NY 10027-5901 | 2020-09-25 |
| 1235746199 | Christopher Alexis Perez Lizardo | Student in an Organized Health Care Education/Training Program | 515 W 59th St Apt 29b, New York, NY 10019-1042 | 2020-09-24 |
| 1568077014 | Toshihide Kuroe | Student in an Organized Health Care Education/Training Program | 35-20 90th Street, Jackson Heights, Queens, New York, NY 11372 | 2020-09-11 |
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| 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.