Individual
DR. ROXANN VINELLE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
111 JOHN ST RM 1450, NEW YORK, NY 10038
(212) 791-5700
(212) 791-5700
Mailing address
111 JOHN ST RM 1450, NEW YORK, NY 10038-3122
(122) 791-5700
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
006461
NY
213ES0131X
Foot Surgery Podiatrist
Primary
006461
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303480059
—
NY
Enumeration date
01/26/2011
Last updated
07/13/2018
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