Most Relevant Information
Provider Data
| NPI Number: | 1003309287 |
| Provider Name: | LOURDES CLARK |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/12/2018 |
| Last Updated: | 09/08/2023 |
Provider Practice Location
4 LORRAINE AVE
MOUNT VERNON
NY
105531222
Practice Location Phone/Fax
| Phone: | 9146637070 |
| Fax: | 9146637075 |
Provider Mailing Location
300 HAYWARD AVE APT GRA
MOUNT VERNON
NY
105521736
Provider Mailing Phone/Fax
| Phone: | 9148431997 |
| Fax: |