Individual
DR. DANE E CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3674
(732) 442-3700
Mailing address
66 W GILBERT ST, 2ND FL, RED BANK, NJ 07701-4918
(721) 212-0060
(732) 212-0061
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA06703000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26085
UHP NON-PAR#
NJ
05
—
7502907
—
NJ
01
—
P00603903
MEDICARE RAILROAD CARRIER
NJ
Enumeration date
08/09/2005
Last updated
03/06/2015
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