Gary Kirven Clarke, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

181214-1 Issued in NY

Practice address

Vamc
79 Middleville Rd
Northport, NY 11768

Phone

(631) 261-4400

Fax

(631) 266-6015

NPI assigned

Sep 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CMC Housestaff

  dba St Vincents Catholic Medical Center

  • Family Medicine Physician
  • Elmhurst, NY
  • NPI 1063572212
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265537864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VAMC NORTHPORT",
            "address_2": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "11768",
            "telephone_number": "631-261-4400",
            "fax_number": "631-266-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VAMC",
            "address_2": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "11768",
            "telephone_number": "631-261-4400",
            "fax_number": "631-266-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "GARY",
        "middle_name": "KIRVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "181214-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Choi, PHARM.D.
• Lori Ann Christianson, P.T.
• Chrystyne Olivieri NP Family Health PLLC
• Frances Ann Ciorra, L.M.S.W.
• City Medical of Upper East Side, PLLC (CityMD)
• Michael P Cogan, CRNA
• Amy Rachael Cohen, M.S.W.
• Dana Ruth Cohen, MD
• Jennifer Webster Cohen, RN
• Kenneth R Cohen, PHARMD, PH. D., RPH.

• Anatomic Pathology & Clinical Pathology Physician in Northport, NY
• Providers in Northport, NY by specialty
• Anatomic Pathology & Clinical Pathology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.