Individual
DEBORAH RENEE BLADES-CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 PENN PLZ, 7TH FLOOR, SUITE 725, NEW YORK, NY 10119-0002
(917) 626-8996
Mailing address
1 PENN PLZ, 7TH FLOOR, SUITE 725, NEW YORK, NY 10119-0002
(917) 626-8996
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
301854
NY
363LA2200X
Adult Health Nurse Practitioner
3018541
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01915388
—
NY
Enumeration date
08/03/2006
Last updated
12/19/2017
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