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NPI Code Detail

MEDICARE: CHERYL CLARKE

MEDICARE:   CHERYL  CLARKE
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
1164W00000XLicensed Practical Nurse321821NY

General Provider Information

NPI Number : 1598203846
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL CLARKE
Provider Business Mailing Address
First Line : 1093 E 72ND ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-5328
Country : US
Telephone Number : 347-604-3232
Fax Number :
Provider Business Practice Location Address
First Line : 1093 E 72ND ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-5328
Country : US
Telephone Number : 347-604-3232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2017
Last Update Date : 02/07/2017

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Directions to “ CHERYL CLARKE ” Practice Location

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