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Individual

CLARK S CASSONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN, FNP-BC

Contact information

Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 724-9197
Mailing address
450 BROOKLINE AVE, BOSTON, MA 02215-5450
(617) 632-6464
(617) 632-6180

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2269715
MA
363LF0000X
Family Nurse Practitioner
RN2269715
MA

Other

Enumeration date
08/09/2012
Last updated
01/03/2024
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