Laura Clark
Nutritionist in Staten Island, NY. Individual provider (NPI-1).
NPI number1316657166
StatusActive
Last updated in NPPESDec 2, 2022
Details
- NPI
- 1316657166
- Entity type
- Individual (NPI-1)
- Name
- Laura Clark
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 2, 2022
- Certification date
- Dec 2, 2022
- Last updated
- Dec 2, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133N00000X | Nutritionist | – | – | Yes |
Practice location
1498 Clove RdStaten Island, NY 10301-4314
Phone 718-494-2690
Mailing address
32 Allen CtStaten Island, NY 10310-2703
Phone 718-640-7774
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 10 Nutritionist providers in Staten Island · All 15,106 providers in Staten Island
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