Individual
CLYDE LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3804 28TH AVENUE, ASTORIA, NY 11103-3313
(718) 278-3800
(718) 278-3318
Mailing address
3804 28TH AVE, ASTORIA, NY 11103-3313
(718) 278-3800
(718) 278-3318
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
093260
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01425727
—
NY
Enumeration date
02/13/2007
Last updated
07/08/2007
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