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General NPI Number Information
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NPI Number | 1871696948
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Entity Type | Individual
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Provider Name | CLINTON MARK HO OD
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Gender | Male
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 76 ORCHARD ST FRONT 1
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City | NEW YORK
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State | NY
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Zip | 10002-4511
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Country | US
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Telephone | 212-533-1707
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Fax | 212-533-1779
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Provider Business Mailing Address
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Address Line | 76 ORCHARD ST FRONT 1
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City | NEW YORK
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State | NY
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Zip | 10002-4511
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Country | US
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Telephone | 212-533-1707
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Fax | 212-533-1779
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV006376
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License Number State | NY
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