Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 008626 | NY |
NPI | 1013438324 |
---|---|
Provider Name | Rashida Clarke |
First Address | Rochester, NY 14625-1330 |
Second Address | Victor, NY 14564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2017 |
Last Update Date | 05/07/2017 |