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General NPI Number Information
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NPI Number | 1619488368
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Entity Type | Individual
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Provider Name | HILLARY ANN CLARKE PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/21/2017
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 330 BROOKLINE AVE
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City | BOSTON
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State | MA
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Zip | 02215-5400
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Country | US
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Telephone | 617-667-3940
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Fax |
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Provider Business Mailing Address
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Address Line | 63 RAYMOND RD
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City | CONCORD
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State | MA
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Zip | 01742-5732
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Country | US
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Telephone | 978-505-3802
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA6338
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License Number State | MA
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