Individual provider · Type 1 NPI

Shannon Law-Clark, PA-C

Surgical Physician Assistant · Montclair, NJ

NPI number 1861177370 Active

Practice location

1 Seymour St
Montclair, NJ 07042-3771

Call (973) 302-6025 Map

Fax (862) 357-8424

Mailing address

54A Hercules Rd
Kenvil, NJ 07847-2674

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X25MP00788200 (NJ)
Physician Assistant 363A00000X25MP00788200 (NJ)

Surgical Physician Assistant: Definition to come...

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About NPI 1861177370

Shannon Law-Clark, PA-C's National Provider Identifier is 1861177370, issued on Jun 21, 2023. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Montclair, NJ. The record was last updated on Sep 13, 2023.