Individual
GLENASIA CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 PARSONS BLVD, FLUSHING, NY 11355-2205
(646) 703-3919
Mailing address
3463 CORSA AVE APT 4A, BRONX, NY 10469-1937
(347) 928-8978
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
NY
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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