Provider Demographics
NPI:1215677711
Name:CLARKE, EUTRIS (FNP)
Entity type:Individual
Prefix:
First Name:EUTRIS
Middle Name:
Last Name:CLARKE
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 E 239TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-1230
Mailing Address - Country:US
Mailing Address - Phone:347-641-2054
Mailing Address - Fax:
Practice Address - Street 1:2519 AVENUE O
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-5230
Practice Address - Country:US
Practice Address - Phone:718-787-1900
Practice Address - Fax:718-787-0897
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY658406163W00000X
NY347468363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse