# DR. KILDARE CLARKE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1104132190
- **Gender:** Man
- **Credential:** MD JD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 132990 | NY | Yes |
| 207Q00000X | Family Medicine Physician | 132990 | NY | — |
| 2083X0100X | Occupational Medicine Physician | 132990 | NY | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 132990 | NY | — |
| 2084F0202X | Forensic Psychiatry Physician | 132990 | NY | — |
| 2084P0015X | Psychosomatic Medicine Physician | 132990 | NY | — |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | 132990 | NY | — |
| 251B00000X | Case Management Agency | 132990 | NY | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | 132990 | NY | — |
| 282N00000X | General Acute Care Hospital | 132990 | NY | — |
| 305S00000X | Point of Service | 132990 | NY | — |

## Other

- **Enumeration date:** 08/27/2010
- **Last updated:** 08/27/2010