Individual
JESSICA CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-3570
(718) 334-3557
Mailing address
7901 BROADWAY, ELMHURST, NY 11373-1329
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
290556
NY
Other
Enumeration date
05/11/2015
Last updated
06/18/2019
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