Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 272606 | NY |
N | 111NI0900X | Internist | 272606 | NY |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 272606 | NY |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 63763 | CT |
N | 207RC0000X | Internist - Cardiovascular Disease | 272606 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | 63763 | CT |
NPI | 1649563073 |
---|---|
Provider Name | Dr. Kevin Clerkin |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-3720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2011 |
Last Update Date | 13/04/2020 |