Lake, Clifton Rudolph

Lake, Clifton Rudolph is an sole proprietor health care provider with primary practice located at 46 Brook Rd , Valley Stream NY 11581-2416. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Hospitals / Psychiatric Hospital. Hospitals / Psychiatric Hospital is his primary health care specialty. Lake, Clifton Rudolph can be contacted via phone (516) 508-0128.

Contact Information

Primary practice address
46 Brook Rd Valley Stream NY 11581-2416
Phone: (516) 508-0128
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ACN1119 Florida
Hospitals / Psychiatric Hospital 283Q00000X P60621 New York

Profile Details

NPI number 1063698330
LBN Legal business name Lake, Clifton Rudolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2008
Last updated May 20th, 2020 - about 6 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.

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