National Provider Identifier
Kevin Clark, PA-C
Kevin Clark, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Boston, MA and a listed phone number of (617) 724-4100.
Source: public NPPES record, last updated October 12, 2021. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1790454726
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- September 13, 2021
- Last Updated
- October 12, 2021
Practice Location
- 55 Fruit St
- Boston, MA 02114-2696
Phone: (617) 724-4100
Mailing Address
- 1675 Washington St Apt 1
- Boston, MA 02118-3485
Specialties
- Physician Assistant (363A00000X)
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Biography
Kevin Clark, PA-C, is a physician assistant in NYU Langone Health’s Ronald O. Perelman Department of Emergency Medicine, where he is listed among the department’s emergency medicine advanced practice providers. A CMS-derived public profile associates him with New York University’s medical group and reports that he graduated in 2021.
Full Record
- NPI
- 1790454726
- Entity Type
- Individual
- Last Name
- Clark
- First Name
- Kevin
- Credential
- PA-C
- Mailing Street Address
- 1675 Washington St Apt 1
- Mailing City
- Boston
- Mailing State
- MA
- Mailing ZIP Code
- 02118-3485
- Mailing Country
- US
- Mailing Phone
- (518) 209-6575
- Practice Street Address
- 55 Fruit St
- Practice City
- Boston
- Practice State
- MA
- Practice ZIP Code
- 02114-2696
- Practice Country
- US
- Practice Phone
- (617) 724-4100
- Enumeration Date
- September 13, 2021
- Last Updated
- October 12, 2021
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- October 12, 2021
- Taxonomies
- Physician Assistant (363A00000X)