Individual
TERENCE JOSEPH CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
222853
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000072573
GHI-HMO
NY
01
—
000415749001
BLUE SHIELD
NY
01
—
050127000002
FIDELIS
NY
01
—
10088694
CDPHP
NY
01
—
11323390
CAQH
NY
01
—
3715H1
BLUE CROSS
NY
01
—
5996001
GHIPPO
NY
01
—
7370593
AETNA
NY
01
—
7515N2
BLUE CROSS
NY
01
—
782956
MVP
NY
Enumeration date
05/16/2006
Last updated
03/27/2023
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