Dora Clark (NPI# 1760559033, PAC ID# 7214036987) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
Nation Provider ID (NPI) | 1760559033 |
PAC ID by PECOS | 7214036987 |
Professional Enrollment ID | I20080512000156 |
Full Name | Dora Clark |
Organization Legal Name | ROGER WILLIAMS RADIATION THERAPY, LLC |
Address |
50 Maude St Providence RI 02908-4325 |
Phone Number | 4014562690 |
Gender | F |
Credential | PA |
Medical School | DUKE UNIVERSITY SCHOOL OF MEDICINE |
Graduation Year | 2006 |
Primary Specialty | PHYSICIAN ASSISTANT |
Group Practice PAC ID | 3476658188 |
Number of Group Practice Members | 15 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
410009 | KENT COUNTY MEMORIAL HOSPITAL |
410011 | LANDMARK MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
1539 Atwood Ave, Suite 203, Johnston, RI 02919-3262 | 4014212110 | ROGER WILLIAMS RADIATION THERAPY, LLC |
50 Maude St, Providence, RI 02908-4325 | 4014562690 | ROGER WILLIAMS RADIATION THERAPY, LLC |
Organization Legal Name | ROGER WILLIAMS RADIATION THERAPY, LLC |
Physicians | 14 |
Name | Specialty | Organization | Address |
---|---|---|---|
Alexander L Lubin | Urology | Roger Williams Radiation Therapy, LLC | 207 Quaker Ln, Fl 1, West Warwick, RI 02893-2179 |
Prakash B Chougule | Radiation Oncology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Vincent A Catallozzi | Urology | Roger Williams Radiation Therapy, LLC | 191 Social St, 6th, Woonsocket, RI 02895-3240 |
Alexandra Sherman | Radiation Oncology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Joseph C Cambio | Urology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Timothy D Shafman | Radiation Oncology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Atip Chatsudthipong | Urology | Roger Williams Radiation Therapy, LLC | 207 Quaker Ln, Fl 1, West Warwick, RI 02893-2179 |
Angelo J Cambio | Urology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Joseph A. Cambio | Urology | Roger Williams Radiation Therapy, LLC | 191 Social St, 6th, Woonsocket, RI 02895-3240 |
Angela K. Derobertis | Radiation Oncology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Street Address |
50 MAUDE ST |
City | PROVIDENCE |
State | RI |
Zip | 02908-4325 |
Name | Specialty | Organization | Address |
---|---|---|---|
Elinor M Collins | Certified Clinical Nurse Specialist (cns) | Prospect Chartercare Rwmc, LLC | 50 Maude St, Providence, RI 02908-4325 |
Michael Mariorenzi | Orthopedic Surgery | Prospect Chartercare Rwmc, LLC | 50 Maude St, Providence, RI 02908-4325 |
Prakash B Chougule | Radiation Oncology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Steven Carl Katz | Surgical Oncology | Prospect Chartercare Rwmc, LLC | 50 Maude St, Providence, RI 02908-4325 |
Gregory James Austin | Orthopedic Surgery | Prospect Chartercare Rwmc, LLC | 50 Maude St, Providence, RI 02908-4325 |
Alexandra Sherman | Radiation Oncology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Carrie M Reynolds | General Practice | Integrated Wound Care Rhode Island Pllc | 50 Maude St, Providence, RI 02908-4325 |
Joseph C Cambio | Urology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Thomas P Cesaro | Optometry | Providence Eye Associates, Inc. | 50 Maude St, Providence, RI 02908-4325 |
Timothy D Shafman | Radiation Oncology | Roger Williams Radiation Therapy, LLC | 50 Maude St, Providence, RI 02908-4325 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Edward T Gallucci | Chiropractic | 1337 Smith St, North Providence, RI 02908-1823 | |
Sean Manchester | Clinical Social Worker | 19 Trinity Pkwy, Providence, RI 02908-1932 | |
Nicholas Bruno | Physical Therapy | 667 Academy Ave, Providence, RI 02908-2105 | |
John Charette | Clinical Social Worker | Providence Behavioral Health Associates Inc | 1075 Smith St, Suite 2, Providence, RI 02908-2700 |
Tara Mabel Brannon Bogs | Psychologist, Clinical | Providence Behavioral Health Associates Inc | 1075 Smith St, Suite 2, Providence, RI 02908-2700 |
Leah Elizabeth Shavalier | Psychologist, Clinical | Providence Behavioral Health Associates Inc | 1075 Smith St, Suite 2, Providence, RI 02908-2700 |
Catherine Hoefliger-gallo | Psychologist, Clinical | Providence Behavioral Health Associates Inc | 1075 Smith St, Suite 2, Providence, RI 02908-2700 |
Randi J Braunstein | Clinical Social Worker | Providence Behavioral Health Associates Inc | 1075 Smith St, Suite 2, Providence, RI 02908-2700 |
Michael D Brodeur | Psychologist, Clinical | Providence Behavioral Health Associates Inc | 1075 Smith St, Suite 2, Providence, RI 02908-2700 |
Terri Lupoli | Clinical Social Worker | Providence Behavioral Health Associates Inc | 1075 Smith St, Suite 2, Providence, RI 02908-2700 |
Find all physicians in zip 02908 |
City | PROVIDENCE |
Zip Code | 02908 |
Specialty | PHYSICIAN ASSISTANT |
City + Specialty | PROVIDENCE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Dora Clark.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.