| Peter Clark, Md, Pc | |
|
220 W South St Groton NY 13073-1237 | |
| (607) 898-3341 | |
| (607) 898-3982 |
| Full Name | Peter Clark, Md, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 220 W South St, Groton, New York |
| Authorized Official Name and Position | Peter Clark (PRESIDENT) |
| Authorized Official Contact | 6078983341 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Clark, Md, Pc 220 W South St Groton NY 13073-1237 Ph: () - | Peter Clark, Md, Pc 220 W South St Groton NY 13073-1237 Ph: (607) 898-3341 |
| NPI Number | 1790970937 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 09/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790970937 | NPI | - | NPPES |
| 01314507 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 181768 (New York) | Primary |
Kwei Ham Daniel Tan, Do Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 Sykes St, Groton, NY 13073 Phone: 607-591-5349 Fax: 607-428-5077 |