Individual
ALYSSA CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
724 WAYPARK AVE, UNIONDALE, NY 11553-2627
(516) 782-4596
Mailing address
724 WAYPARK AVE, UNIONDALE, NY 11553-2627
(516) 782-4596
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
320979-1
NY
Other
Enumeration date
01/24/2015
Last updated
01/24/2015
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