Individual
JEANETTE CRISTINE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
24 ROBERTS ST, FARMINGDALE, NY 11735-5042
(516) 293-0051
Mailing address
750 SHORE RD APT 5C, LONG BEACH, NY 11561-4735
(732) 887-7093
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
861777-01
NY
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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