Individual
CLARK RAYMOND GENTILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
159 20TH ST, BROOKLYN, NY 11232-1253
(646) 685-4422
Mailing address
128 MARINE AVE APT 6D, BROOKLYN, NY 11209-7545
(347) 674-7783
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
015535
NY
Other
Enumeration date
05/17/2021
Last updated
08/11/2025
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