Individual
CHARLOTTE M CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 WEBSTER AVE, NEW ROCHELLE, NY 10801-3206
(718) 362-1411
(718) 414-1651
Mailing address
228 E ROUTE 59 # 408, NANUET, NY 10954-2905
(718) 362-1411
(718) 414-1651
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
286912
NY
282N00000X
General Acute Care Hospital
—
—
Other
Enumeration date
05/21/2009
Last updated
04/30/2018
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