Provider Demographics
NPI:1588175541
Name:MARSFELDER-CLARK, HILARY (CNM)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:MARSFELDER-CLARK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 PRESIDENTIAL PLAZA
Mailing Address - Street 2:3RD FL
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202
Mailing Address - Country:US
Mailing Address - Phone:315-464-4458
Mailing Address - Fax:315-464-6388
Practice Address - Street 1:90 PRESIDENTIAL PLAZA
Practice Address - Street 2:3RD FL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202
Practice Address - Country:US
Practice Address - Phone:315-464-4458
Practice Address - Fax:315-464-6388
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001828176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04909871Medicaid