Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAQUELL CLARK
Active Sole ProprietorJAQUELL CLARK is a Registered Nurse healthcare provider located in MEDFORD, New York. NPI 1407732001 is currently active in the NPPES registry. Verify at CMS.
Registered Nurse · MEDFORD, NY
Registration Details
- NPI Number
- 1407732001
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 12, 2025 (1.021353169744 yrs)
- Last Updated
- Aug 12, 2025
- License
-
849553 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
97 MAPLE LNMEDFORD, NY, 117631028Browse NY providers · Browse ZIP 11763
- Phone
- 6318827216
- Primary Specialty
-
Registered Nurse
163W00000X
Other Registered Nurse Providers in MEDFORD, NY
| Name | Credential | NPI |
|---|---|---|
| MR. JOSEPH COTTIERS | R.N. | 1336348473 |
| MS. JULAINE MARIE APREA | RN | 1699950444 |
| MRS. KUDIRAT OLUFUNKE ADESANYA | REGISTERED NURSE | 1043489651 |
| MRS. ALLISON CHRISTINE LAFRANCA | LPN | 1376706986 |
| LORIANN SURDOW | R.N. | 1659527752 |
| MISS SUZANNE A TULLON | RN | 1407005622 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.