Organization
EDWARD H CLARKE MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD H CLARKE MD (OWNER)
(607) 733-6698
Entity
Organization
Contact information
Practice address
147 W GRAY ST, ELMIRA, NY 14901-3017
(607) 733-6698
Mailing address
147 W GRAY ST, ELMIRA, NY 14901-3017
(607) 733-6698
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
1039991
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00685823
—
NY
Enumeration date
03/08/2007
Last updated
08/22/2020
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