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1922640721
ROGER CLARK
NEW YORK, NY
NPI
1922640721
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-10-13
Last Update Date
2019-10-13
Business Address
ROGER CLARK
160 CONVENT AVE HARRIS HALL H-15
NEW YORK, NY 10031-9198
Phone number: 212-650-7745
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Mailing Address
ROGER CLARK
2040 GLEASON AVE APT 2K
BRONX, NY 10472-5282
Phone number: 646-939-0733
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