RYAN CLARK PA NPI 1962648121

NPI Information

  • NPI: 1962648121
  • Provider Name: RYAN CLARK, PA
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 5501 OLD YORK RD
    WILLLOWCREST BLDG., 4TH FLOOR
    PHILADELPHIA, PA
    ZIP 19141
  • Phone: (215) 456-1754

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NPI Details

Ryan Clark, PA is a medical physician assistant in Philadelphia, PA. Ryan Clark, PA NPI is 1962648121. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5501 OLD YORK RD
WILLLOWCREST BLDG., 4TH FLOOR
PHILADELPHIA, PA
ZIP 19141-018
Phone: (215) 456-1754

The enumeration date for this NPI number is 12/18/2008 and was last updated on 12/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalMA053613PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1232664784OTHERPENNSYLVANIAEIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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