Janeen Clark

Individual provider Active NPI Registered Nurse · Beechhurst, NY

NPI 1750258331 · NPPES record last updated Oct 20, 2025

Key facts

NPI
1750258331
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
696361 (NY)
Practice address
2103 Murray St
Beechhurst, NY 11357-3736
Phone
(917) 817-2990
NPI assigned
Oct 20, 2025
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
696361NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse
Group: 193400000X SINGLE SPECIALTY GROUP
163W00000X 696361 NY Yes

Addresses

Primary practice location

2103 Murray St
Beechhurst, NY 11357-3736

Mailing address

2103 Murray St
Beechhurst, NY 11357-3736
Phone (917) 817-2990

Other providers in Beechhurst, NY

All providers in Beechhurst, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.