Individual
DR. KELLY RAE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
130 W KINGSBRIDGE RD, BRONX, NY 10468-3904
(718) 584-9000
Mailing address
130 W KINGSBRIDGE RD, BRONX, NY 10468-3904
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
41224
TX
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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