Individual
JAN CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Mailing address
180 W TODD ST, HAMDEN, CT 06518-1106
(203) 903-5174
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036-064554
IL
207RR0500X
Rheumatology Physician
036-064554
IL
Other
Enumeration date
08/06/2006
Last updated
09/30/2016
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