Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 208242 | NY |
NPI | 1003929209 |
---|---|
Provider Name | Dr. Colin Clarke |
First Address | Manhasset, NY 11030-1945 |
Second Address | Manhasset, NY 11030-1945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 05/02/2017 |