Individual provider · Type 1 NPI

Colleen Rose Clark

Student in an Organized Health Care Education/Training Program · East Orange, NJ

NPI number 1265315683 Active

Practice location

385 Tremont Ave
East Orange, NJ 07018-1023

Call (973) 676-1000 Map

Mailing address

39 Bosworth St
Staten Island, NY 10310-2809

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1265315683

Colleen Rose Clark's National Provider Identifier is 1265315683, issued on Jul 31, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in East Orange, NJ. The record was last updated on Jul 31, 2025.