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General NPI Number Information
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NPI Number | 1467351361
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Entity Type | Individual
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Provider Name | HOWARD CLARK SR.
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Gender | Male
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 251-03 CULLMAN AVE
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City | LITTLE NECK
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State | NY
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Zip | 11362-1216
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Country | US
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Telephone | 718-423-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 1365 SAINT NICHOLAS AVE APT 7J
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City | NEW YORK
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State | NY
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Zip | 10033-6203
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Country | US
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Telephone | 718-540-2142
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | NY
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