person
Lisa M Clark, CPNP-AC
Pediatric Nurse Practitioner in Stony Brook, New York
NPI 1710146220

Lisa M Clark is a Pediatric Nurse Practitioner based in Stony Brook, NY and is specialized in Pediatrics. Lisa M Clark practices in Stony Brook, NY and has the professional credentials of CPNP-AC. The NPI Number for Lisa M Clark is 1710146220 and holds a License No. 380567 (New York).

The current practice location address for Lisa M Clark is University Hosp Medical Center Stony Brk, Stony Brook, NY and can be reached out via phone at 631-444-2967 and via fax at 631-444-6212.

Location: University Hosp Medical Center Stony Brk, Stony Brook, NY, 11794-8111
person
Provider Profile Details
NPI Number
1710146220
Provider Name
Lisa M Clark
Credential
CPNP-AC
Provider Entity Type
Individual
Gender
Female
Address
University Hosp Medical Center Stony Brk, Stony Brook, NY, 11794-8111
Phone Number
631-444-2967
Fax Number
631-444-6212
Provider Enumeration Date
06/09/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
380567 01 NY NYS LICIENCE NUMBER
institution
Provider Business Practice Location Address Details
Address
University Hosp Medical Center Stony Brk
City
State
Zip
11794-0001
Phone Number
631-444-2967
Fax Number
631-444-6212
person
Provider Business Mailing Address Details
Address
University Hosp Medical Center Stony Brk
City
State
Zip
11794-0001
Phone Number
631-444-2967
Fax Number
631-444-6212
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
380567 (New York)
Definition
Definition to come...
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