Clarke, Fred
Clarke, Fred is an sole proprietor health care provider with primary practice located at 20016 Hollis Avenue , Jamaica NY 11412. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Clarke, Fred can be contacted via phone (718) 736-8204.Contact Information
Primary practice address
20016 Hollis Avenue
Jamaica NY 11412
Phone: (718) 736-8204
Fax: (718) 736-8505
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 206376 | New York |
Profile Details
| NPI number | 1346206950 |
|---|---|
| LBN Legal business name | Clarke, Fred |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 22nd, 2006 |
| Last updated | Jan 18th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346206950 | NPPES |
| New York | MEDICAID | 01862739 |
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