Individual
DR. DEBRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1409 RT 9, KEESEVILLE, NY 12944-2845
(518) 834-7271
(518) 834-7086
Mailing address
1409 RT 9, KEESEVILLE, NY 12944-2845
(518) 834-7271
(518) 834-7086
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1750471
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01604324
—
NY
Enumeration date
02/01/2006
Last updated
11/20/2023
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