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

Mr. Timothy Jerum Clark, NP

Individual provider Family Nurse Practitioner · NPI 1518492008

Mr. Timothy Jerum Clark, NP is a Family Nurse Practitioner in Staten Island, New York. Licensed in New York and Pennsylvania. Registered with an NPI since 2017.

Licensed in
NY, PA
In the registry since
2017
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

246 Hart Ave
Staten Island, NY 10310-3022
Phone: (347) 306-8981
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence SP017303 (PA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 341667 (NY)

Record details

NPI number1518492008
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedApril 22, 2017
Last updated in NPPESMarch 30, 2021
Certification dateMarch 30, 2021

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