Healthcare Provider Details

I. General information

NPI: 1609716471
Provider Name (Legal Business Name): ANASIA CLARKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CORPORATE BLVD S
YONKERS NY
10701-6862
US

IV. Provider business mailing address

60 N 8TH AVE
MOUNT VERNON NY
10550-1912
US

V. Phone/Fax

Practice location:
  • Phone: 914-294-6148
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN32826
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: