Individual
JOSEPHINE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2094 PITKIN AVE, BROOKLYN, NY 11207-3509
(718) 240-0400
Mailing address
843 EDWARD ST, NORTH BALDWIN, NY 11510-1411
(718) 490-9010
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
514226
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402224
NY
Other
Enumeration date
07/28/2017
Last updated
07/28/2017
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