Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sports Extra PC

Organization Sports Medicine (Family Medicine) Physician · NPI 1346296969

Sports Extra PC is a Sports Medicine (Family Medicine) Physician in Clark, New Jersey. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

67 Walnut Ave Ste 202
Clark, NJ 07066-1640
Phone: (732) 388-7300
Fax: (732) 388-1330
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1346296969
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michele Gilsenan — Practice Owner · (732) 388-7300
NPI enumeratedMay 25, 2006
Last updated in NPPESOctober 18, 2007
Mailing address67 Walnut Ave, Suite 202, Clark, NJ 07066-1640

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