Individual
ELSA JIMENEZ CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1259 WANTAGH AVE, WANTAGH, NY 11793-2205
(516) 221-7971
(516) 221-8117
Mailing address
1259 WANTAGH AVE, WANTAGH, NY 11793-2205
(516) 221-7971
(516) 221-8117
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
186750
NY
Other
Enumeration date
06/28/2005
Last updated
06/24/2008
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