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Individual

CLAIRE JOHNSTON TUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-6628
Mailing address
800 CHESAPEAKE PL, GREENVILLE, NC 27858-6239
(252) 531-6332

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
028959-01
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/11/2022
Last updated
03/08/2023
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