PROF. MARIEL CLARK (NPI# 1568475523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568475523 |
| Entity Type | Individual |
| Full Name | PROF. MARIEL CLARK |
| Credential | P.A.,C. |
| Practice Address |
9501 Roosevelt Blvd Suite 410 Philadelphia PA 19114-1025 |
| Practice Telephone | 2159694917 |
| Practice Fax Number | 2159695875 |
| Mailing Telephone | 2159694917 |
| Mailing Fax Number | 2159695875 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA000134L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013343607 | Mariel Lakeitha Clark | Psychologist | 191 Katherine Ave, Ozark, AL 36360-1976 | 2013-09-16 |
| Street Address |
9501 ROOSEVELT BLVD SUITE 410 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19114-1025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405936 | Anthony Brandimarto | Internal Medicine | 9501 Roosevelt Blvd, Ste 501, Philadelphia, PA 19114-1030 | 2005-05-24 |
| 1508403569 | Galyna Vorokhib | Nurse Practitioner | 9501 Roosevelt Blvd, Philadelphia, PA 19114-1025 | 2019-12-09 |
| 1003301920 | Johanna Marie Farinella | Nurse Practitioner | 9501 Roosevelt Blvd, Philadelphia, PA 19114-1025 | 2018-06-22 |
| 1487190096 | Allen Shapiro | Dentist | 9501 Roosevelt Blvd, Ste 409, Philadelphia, PA 19114-1025 | 2017-01-07 |
| 1124560081 | Aria Health Physician Services | Internal Medicine | 9501 Roosevelt Blvd, Suite 400, Philadelphia, PA 19114-1025 | 2016-11-09 |
| 1285187260 | Marianna Diloyan | Registered Nurse | 9501 Roosevelt Blvd, Suite 206, Philadelphia, PA 19114-1025 | 2016-07-26 |
| 1487009312 | Dr. Allen P. Shapiro Dds.ltd | Clinic/Center | 9501 Roosevelt Blvd, Suite 409, Philadelphia, PA 19114-1025 | 2016-04-28 |
| 1568880334 | Barry B Abraham Md LLC | Dermatology | 9501 Roosevelt Blvd, Suite 506, Philadelphia, PA 19114-1030 | 2014-03-31 |
| 1023388196 | Oasis Oral Surgery LLC | Dentist | 9501 Roosevelt Blvd, Suite 101, Philadelphia, PA 19114-1025 | 2012-01-06 |
| 1891928214 | Brian Shapiro | Dentist | 9501 Roosevelt Blvd, Suite 409, Philadelphia, PA 19114-1025 | 2009-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029906 | Phuoc Nguyen | Nurse Anesthetist, Certified Registered | Jefferson Torresdale Hospital, 10800 Knights Rd, Philadelphia, PA 19114 | 2020-10-05 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1215419080 | Thomas Patrick Gallagher | Specialist/Technologist | 2708 Ruth Way, Philadelphia, PA 19114 | 2018-08-29 |
| 1558840223 | Alexis Wenger | Early Intervention Provider Agency | 3810 Aubrey Ave, Phila, PA 19114 | 2018-08-13 |
| 1245759232 | Newlands Health | Clinic/Center | 9625 Frankford Ave., Philadelphia, PA 19114 | 2017-09-12 |
| 1619491453 | Nazareth Physician Services Inc | Social Worker | 9815 Roosevelt Blvd Ste G, Philadelphia, PA 19114 | 2017-08-02 |
| 1326561606 | L.s. Share & Love Support Coordinating Agency, LLC | Case Management | 3600 Red Lion Road, Apt 68c, Philadelphia, PA 19114 | 2017-07-19 |
| 1760911952 | Charles C Richards II | Counselor | 2555 Welsh Rd, Apt 407, Philadelphia, PA 19114 | 2017-06-09 |
| 1801338686 | April Neuls | Physical Therapy Assistant | 4213 Lackland Place, Philadelphia, PA 19114 | 2016-11-10 |
| 1114317583 | Siji Cyriac | Physical Therapist | 9501 State Road, Philadelphia, PA 19114 | 2015-01-23 |
| Find all providers in zip 19114 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283986 | Margaret Ann Malloy | Physician Assistant | 3223 N Broad St Fl 1, Philadelphia, PA 19140-5007 | 2020-10-20 |
| 1174122493 | Juliana Debnam | Physician Assistant | 235 S 15th St Apt 904, Philadelphia, PA 19102-5031 | 2020-10-19 |
| 1457950867 | Kyllington Spotts | Physician Assistant | 1151 N 3rd St Unit 301, Philadelphia, PA 19123-1578 | 2020-10-19 |
| 1598375925 | Meredith Jeanne Behr | Physician Assistant | 5401 N Broad St, Philadelphia, PA 19141 | 2020-07-31 |
| 1457977944 | Jiyean Yoo | Physician Assistant | 2929 Walnut St Apt 4424, Philadelphia, PA 19104-5096 | 2020-06-19 |
| 1356987747 | Jennifer Rose Cueni | Physician Assistant | 2120 Brandywine St, Philadelphia, PA 19130-3107 | 2019-11-21 |
| 1730740408 | Olivia Anne Leventry | Physician Assistant | 109 Fairmount Ave, Philadelphia, PA 19123-3004 | 2019-06-24 |
| 1588136055 | Jefferson University Physcians | Physician Assistant | 1020 Sansom St Fl 10, Philadelphia, PA 19107-5002 | 2018-12-21 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922589365 | Rachel Diane Simonsen | Physician Assistant | 1741 Frankford Ave Ste 100a, Philadelphia, PA 19125-2445 | 2018-08-23 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19114 |
Please comment or provide details below to improve the information on PROF. MARIEL CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.