Individual
ALEXANDER CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
181 RIDGE RD, VALLEY COTTAGE, NY 10989-2353
(917) 470-0152
Mailing address
181 RIDGE RD, VALLEY COTTAGE, NY 10989-2353
(917) 470-0152
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
841723-01
NY
164W00000X
Licensed Practical Nurse
315947
NY
Other
Enumeration date
07/01/2016
Last updated
07/25/2024
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