Individual
KEVIN O. CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 BERGEN ST, DOC 7100, NEWARK, NJ 07103-2425
(973) 972-2400
(973) 972-2988
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
25MA07226400
NJ
Other
Enumeration date
07/27/2006
Last updated
08/21/2009
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