Individual ProviderCynthia ClarkDietitian, RegisteredDietary & Nutritional Service ProvidersPractice Address110 Irving St NW, Washington Ca Institute - Rm. C1213, Washington, DC 20010-2976(202) 877-3498(301) 257-3299PECOS EnrollmentBased on the most recent information from CMS, provider Cynthia Clark does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1760490338Provider TypeIndividualFull NameClark, CynthiaTitleMs.CredentialRDGenderFemaleSole ProprietorNoEnumeration Date8/3/2006Last Updated7/9/2007Contact InformationPractice LocationPractice Address110 Irving St NW, Washington Ca Institute - Rm. C1213, Washington, DC 20010-2976Phone(202) 877-3498Fax(202) 877-8539Mailing LocationMailing Address5304 Crestedge Ln, Rockville, MD 20853-2503Phone(301) 257-3299FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode133V00000XPrimaryDescriptionDietitian, RegisteredDietary & Nutritional Service ProvidersLicenseUnlisted IssuerDistrict of Columbia