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NPI Code Detail

MEDICARE: COLIN CLARKE M.D. P.C.

MEDICARE: COLIN CLARKE M.D. P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician208242-8NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487760963
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLIN CLARKE M.D. P.C.
Provider Business Mailing Address
First Line : PO BOX 350185
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-0185
Country : US
Telephone Number : 718-743-6225
Fax Number : 866-317-2671
Provider Business Practice Location Address
First Line : 2518 OCEAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-3916
Country : US
Telephone Number : 718-934-5395
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. COLIN CLARKE
Credential : M.D.
Telephone Number : 516-456-8077
Provider Enumeration Date : 08/21/2006
Last Update Date : 08/22/2020

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