Mrs Genese Calloway Clark, is a
Case Manager/care Coordinator based in New Haven, Connecticut. Mrs Genese Calloway Clark is licensed to practice in * (Not Available) (license number ) and her current practice location is
458 Grand Ave Ste 103, New Haven, Connecticut. She can be reached at her office (for appointments etc.) via phone at
(203) 850-4737.
NPI number for Mrs Genese Calloway Clark is 1124668694 and her current mailing address is 458 Grand Ave Ste 103, New Haven, Connecticut. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1124668694.
Healthcare Provider's Profile
| Full Name | Mrs Genese Calloway Clark |
|---|
| Gender | Female |
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| Speciality | Case Manager/care Coordinator |
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| Location | 458 Grand Ave Ste 103, New Haven, Connecticut |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1124668694
- Provider Enumeration Date: 01/13/2020
- Last Update Date: 01/13/2020
Medical Identifiers
Medical identifiers for Mrs Genese Calloway Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124668694 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Genese Calloway Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Genese Calloway Clark,
458 Grand Ave Ste 103,
New Haven, CT 06513-3873
Ph: () - | Mrs Genese Calloway Clark,
458 Grand Ave Ste 103,
New Haven, CT 06513-3873
Ph: (203) 850-4737 |
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