Individual provider · NPI-1

Dr. John Deighton Clarke, MD

Family Medicine · Mineola, NY

NPI number1386868537
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1386868537
Entity type
Individual (NPI-1)
Name
Dr. John Deighton Clarke
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 12, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine215688NYYes

Practice location

173 Mineola Blvd
Suite 101
Mineola, NY 11501-2528

Phone 516-248-3410 · Fax 516-248-3419

Mailing address

173 Mineola Blvd
Suite 101
Mineola, NY 11501-2528

Phone 516-248-3410 · Fax 516-248-3419

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