Edward Clarke, FNP-BC
Nurse Practitioner, Family in New York, NY. Individual provider (NPI-1).
NPI number1962084673
StatusActive
Last updated in NPPESApr 22, 2021
Details
- NPI
- 1962084673
- Entity type
- Individual (NPI-1)
- Name
- Edward Clarke
- Credential
- FNP-BC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 22, 2021
- Certification date
- Apr 22, 2021
- Last updated
- Apr 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F347530-01 | NY | Yes |
Practice location
1470 Madison AveNew York, NY 10029-6542
Phone 212-241-6756
Mailing address
3044 Matthews AveBronx, NY 10467-8606
Phone 718-663-1322
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