Individual
CHEKIRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 KENNEY CT, NEWBURGH, NY 12550-5354
(845) 242-0116
Mailing address
115 KENNEY CT, NEWBURGH, NY 12550-5354
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
346918
NY
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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