PROF. MARIEL CLARK P.A.,C.
NPI 1568475523
Physician Assistant in Philadelphia, PA

Q: What is Mariel Clark's NPI number?

The NPI number for Mariel Clark is 1568475523. It was assigned to this individual provider in the NPPES registry on August 14, 2006.

Q: What is Mariel Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Mariel Clark was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 14, 2006

9501 ROOSEVELT BLVD, SUITE 410, PHILADELPHIA, PA 19114(215) 969-4917(215) 969-5875 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Prof. Mariel Clark P.a.,c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROF. MARIEL CLARK P.A.,C. (NPI 1568475523) is an individual physician assistant in Philadelphia, Pennsylvania, licensed in Pennsylvania (MA000134L) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1568475523

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NamePROF. MARIEL CLARKCredential: P.A.,C.

Location Address9501 ROOSEVELT BLVD, SUITE 410Philadelphia, PA 19114-1025

Mailing Address9501 Roosevelt Blvd, Suite 410Philadelphia, PA 19114-1025 · (215) 969-4917 · Fax (215) 969-5875

Phone(215) 969-4917

Fax(215) 969-5875

Sole ProprietorNo

Enumeration DateAugust 14, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1568475523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in PA · MA000134L

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

9501 ROOSEVELT BLVD, Philadelphia, PA 19114

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