Alyssa Clarke

Individual provider Active NPI Licensed Practical Nurse · Uniondale, NY

NPI 1720478142 · NPPES record last updated Jan 24, 2015

Key facts

NPI
1720478142
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
320979-1 (NY)
Practice address
724 Waypark Ave
Uniondale, NY 11553-2627
Phone
(516) 782-4596
NPI assigned
Jan 24, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
320979-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 320979-1 NY Yes

Addresses

Primary practice location

724 Waypark Ave
Uniondale, NY 11553-2627

Mailing address

724 Waypark Ave
Uniondale, NY 11553-2627
Phone (516) 782-4596

Other providers in Uniondale, NY

All providers in Uniondale, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.