Individual
CARROLL CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3109 HEALY AVE APT B, FAR ROCKAWAY, NY 11691-1839
(929) 545-7964
Mailing address
3109 HEALY AVE APT B, FAR ROCKAWAY, NY 11691-1839
(929) 545-7964
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
325710-01
NY
Other
Enumeration date
07/19/2016
Last updated
03/18/2024
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