Individual
DOMINIQUE SHARICE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPT
Contact information
Practice address
P.O. BOX 1534, BRIDGEHAMPTON, NY 11932-1534
(631) 276-8176
Mailing address
PO BOX 1534, BRIDGEHAMPTON, NY 11932-1534
(631) 276-8176
Taxonomy
Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
Primary
—
—
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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