Matthew Clark (NPI# 1396905188, PAC ID# 8820316904) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is MAXILLOFACIAL SURGERY.
| Nation Provider ID (NPI) | 1396905188 |
| PAC ID by PECOS | 8820316904 |
| Professional Enrollment ID | I20150422000430 |
| Full Name | Matthew Clark |
| Organization Legal Name | NORTHEAST IMPLANT AND ORAL SURGERY, PC |
| Address |
27 Hospital Ave Suite 306 Danbury CT 06810-5961 |
| Phone Number | 2037970008 |
| Gender | M |
| Medical School | COLUMBIA UNIV SCHOOL OF DENTAL & ORAL SURGERY |
| Graduation Year | 2008 |
| Primary Specialty | MAXILLOFACIAL SURGERY |
| Group Practice PAC ID | 7012013790 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330024 | MOUNT SINAI HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 667 Stoneleigh Ave, Suite 301, Carmel, NY 10512-2455 | 8452782101 | NORTHEAST IMPLANT AND ORAL SURGERY, PC |
| 667 Stoneleigh Ave, Carmel, NY 10512-2455 | 8452782101 | NORTHEAST IMPLANT AND ORAL SURGERY, PC |
| 27 Hospital Ave, Suite 306, Danbury, CT 06810-5961 | 2037970008 | NORTHEAST IMPLANT AND ORAL SURGERY, PC |
| 27 Hospital Ave, Danbury, CT 06810-5961 | 2037970008 | NORTHEAST IMPLANT AND ORAL SURGERY, PC |
| Organization Legal Name | NORTHEAST IMPLANT AND ORAL SURGERY, PC |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Edward J Miller | Oral Surgery | Northeast Implant and Oral Surgery, PC | 667 Stoneleigh Ave, Suite 301, Carmel, NY 10512-2455 |
| Richard Salas | Oral Surgery | Northeast Implant and Oral Surgery, PC | 667 Stoneleigh Ave, Suite 301, Carmel, NY 10512-2455 |
| Anthony Cuomo | Oral Surgery | Northeast Implant and Oral Surgery, PC | 667 Stoneleigh Ave, Suite 301, Carmel, NY 10512-2455 |
| Julia Abend | Oral Surgery | Northeast Implant and Oral Surgery, PC | 667 Stoneleigh Ave, Suite 301, Carmel, NY 10512-2455 |
| Christopher Cuomo | Oral Surgery | Northeast Implant and Oral Surgery, PC | 27 Hospital Ave, Suite 306, Danbury, CT 06810-5961 |
| Seth Matton | Oral Surgery | Northeast Implant and Oral Surgery, PC | 27 Hospital Ave, Suite 306, Danbury, CT 06810-5961 |
| Paul Patella | Oral Surgery | Northeast Implant and Oral Surgery, PC | 667 Stoneleigh Ave, Carmel, NY 10512-2455 |
| Street Address |
27 HOSPITAL AVE SUITE 306 |
| City | DANBURY |
| State | CT |
| Zip | 06810-5961 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William A Notaro | Dermatology | 27 Hospital Ave, Suite 406, Danbury, CT 06810-5961 | |
| Patrick Brew | Nurse Practitioner | 27 Hospital Ave, Suite 403, Danbury, CT 06810-5961 | |
| Ziad M Taweh | Internal Medicine | 27 Hospital Ave, Suite 403, Danbury, CT 06810-5961 | |
| Madhuri Nanik Bakhru | Obstetrics/gynecology | 27 Hospital Ave, Suite 201, Danbury, CT 06810-5954 | |
| Della M Schmid | Chiropractic | 27 Hospital Ave, Suite 403, Danbury, CT 06810-5961 | |
| Efren E Rebong | Psychiatry | 27 Hospital Ave, Suite 302, Danbury, CT 06810-5954 | |
| Natalie H Hoeffel | Clinical Social Worker | 27 Hospital Ave, Suite 402, Danbury, CT 06810-5961 | |
| Elizabeth M Kontarines | Obstetrics/gynecology | Women's Health Associates, P.C. | 27 Hospital Ave, Suite 305, Danbury, CT 06810-5961 |
| Christopher Cuomo | Oral Surgery | Northeast Implant and Oral Surgery, PC | 27 Hospital Ave, Suite 306, Danbury, CT 06810-5961 |
| Santha T Kurien | Psychiatry | 27 Hospital Ave, Suite 304, Danbury, CT 06810-5961 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joseph J Moreira | Neurology | 24 Danbury Ave, Danbury, CT 06810 | |
| Michael Baroody | Plastic and Reconstructive Surgery | 51 -53 Kenosia Ave, Suite 201, Danbury, CT 06810-2301 | |
| Amanda G Madkour | Physician Assistant | Urology Associates of Danbury, PC | 51 -53 Kenosia Ave, Danbury, CT 06810-2304 |
| Diane St Pierre | Physician Assistant | Urology Associates of Danbury, PC | 51 -53 Kenosia Ave, Danbury, CT 06810-2304 |
| Edward M Beck | Urology | Urology Associates of Danbury, PC | 51 -53 Kenosia Ave, Danbury, CT 06810-2304 |
| John J Bruno | Urology | Urology Associates of Danbury, PC | 51 -53 Kenosia Ave, Danbury, CT 06810-2304 |
| Lin Li | Pathology | Urology Associates of Danbury, PC | 51 -53 Kenosia Ave, Danbury, CT 06810-2304 |
| Jeffrey I Gorelick | Urology | Urology Associates of Danbury, PC | 51 -53 Kenosia Ave, Danbury, CT 06810-2304 |
| Guy J Manetti | Urology | Urology Associates of Danbury, PC | 51 -53 Kenosia Ave, Danbury, CT 06810-2304 |
| Andrea H Russo | Obstetrics/gynecology | Urology Associates of Danbury, PC | 51 -53 Kenosia Ave, Danbury, CT 06810-2304 |
| Find all physicians in zip 06810 | |||
| City | DANBURY |
| Zip Code | 06810 |
| Specialty | MAXILLOFACIAL SURGERY |
| City + Specialty | DANBURY + MAXILLOFACIAL SURGERY |
Please comment or provide details below to improve the information on Matthew 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.