Individual
MR. DENIS GOULBURN CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
62 EAST 88TH STREET, NEW YORK, NY 10128
(212) 876-7000
Mailing address
115 BAINBRIDGE STREET, BROOKLYN, NY 11233
(917) 257-1362
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003681
NY
Other
Enumeration date
03/22/2011
Last updated
10/22/2014
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