Provider Demographics
NPI:1962229518
Name:CLARKE, JANET MONPLAISER
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:MONPLAISER
Last Name:CLARKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107A DEER PARK RD
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4926
Mailing Address - Country:US
Mailing Address - Phone:631-896-2119
Mailing Address - Fax:
Practice Address - Street 1:107A DEER PARK RD
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-4926
Practice Address - Country:US
Practice Address - Phone:631-896-2119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY385947163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse