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1346206950
FRED CLARKE
JAMAICA, NY
NPI
1346206950
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NY 206376)
Enumeration Date
2006-04-22
Last Update Date
2013-01-18
Business Address
-- FRED CLARKE MD
20016 HOLLIS AVENUE
JAMAICA, NY 11412
Phone number: 718-736-8204
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Mailing Address
-- FRED CLARKE MD
80 MARCUS DR PROVIDER ENROLLMENT
MELVILLE, NY 11747-4230
Phone number: 631-391-7889
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