Individual provider · Type 1 NPI

Jaquell Clark

Registered Nurse · Medford, NY

NPI number 1407732001 Active

Practice location

97 Maple Ln
Medford, NY 11763-1028

Call (631) 882-7216 Map

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse Primary 163W00000X849553 (NY)

Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1407732001

Jaquell Clark's National Provider Identifier is 1407732001, issued on Aug 12, 2025. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Medford, NY. The record was last updated on Aug 12, 2025.