Individual
MS. CARLA ADELLE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
76 WHITTIER DRIVE, THORNWOOD, NY 10594-1714
(914) 747-3292
Mailing address
1014 EAST 220TH ST, BRONX, NY 10469-1201
(718) 654-0438
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
5617191
NY
164W00000X
Licensed Practical Nurse
2601141
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02073870
—
NY
Enumeration date
11/23/2007
Last updated
11/23/2007
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