Shannon Law-Clark, PA-C
Physician Assistant, Surgical in Montclair, New Jersey
1861177370- Practice location
- 1 Seymour St, Montclair, NJ 07042-3771
- Phone
- 973-302-6025
- Fax
- 862-357-8424
- Last updated
- September 13, 2023
Shannon Law-Clark is a Physician Assistant, Surgical based in Montclair, NJ. Shannon Law-Clark practices in Montclair, NJ and has the professional credentials of PA-C. The NPI Number for Shannon Law-Clark is 1861177370 and holds a License No. 25MP00788200 (NJ). The current practice location address for Shannon Law-Clark is 1 Seymour St, Montclair, NJ 07042-3771 and can be reached out via phone at 973-302-6025 and via fax at 862-357-8424.
Provider Profile Details
- NPI Number
- 1861177370
- Provider Name
- Shannon Law-Clark
- Credential
- PA-C
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1 Seymour St, Montclair, NJ 07042-3771
- Phone Number
- 973-302-6025
- Fax Number
- 862-357-8424
- Primary Taxonomy
- Physician Assistant, Surgical · 363AS0400X
- Sole Proprietor
- No
- Provider Enumeration Date
- June 21, 2023
- Last Update Date
- September 13, 2023
- Certification Date
- September 13, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1 Seymour St
Montclair, NJ 07042-3771 - City
- Montclair
- State
- New Jersey
- Zip
- 07042-3771
- Phone Number
- 973-302-6025
- Fax Number
- 862-357-8424
Provider Business Mailing Address Details
- Address
- 54A Hercules RD
Kenvil, NJ 07847-2674 - City
- Kenvil
- State
- NJ
- Zip
- 07847-2674
- Phone Number
- 973-699-7861
License Information
- License Number (1)
- 25MP00788200
- License State (1)
- NJ
- Taxonomy (1)
- Physician Assistant, Surgical · 363AS0400X · Primary
- License Number (2)
- 25MP00788200
- License State (2)
- NJ
- Taxonomy (2)
- Physician Assistant · 363A00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Physician Assistant, Surgical providers near Montclair, NJ
View all Physician Assistant, Surgical providers in Montclair →Frequently Asked Questions
What is the NPI number of Shannon Law-Clark, PA-C?
The NPI number of Shannon Law-Clark, PA-C is 1861177370. It was assigned on June 21, 2023 and is currently active in the NPPES registry.
What is the specialty of Shannon Law-Clark, PA-C?
Shannon Law-Clark, PA-C is registered under the primary taxonomy Physician Assistant, Surgical (code 363AS0400X), licensed in NJ under license number 25MP00788200.
Where does Shannon Law-Clark, PA-C practice?
The practice location is 1 Seymour St, Montclair, NJ 07042-3771. The office can be reached at 973-302-6025 (phone) or 862-357-8424 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1861177370 directly on the NPPES registry website.