Provider Demographics
NPI:1790298073
Name:CONCAR, CLAIRE M (LAC)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:M
Last Name:CONCAR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 HUNT AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1878
Mailing Address - Country:US
Mailing Address - Phone:845-499-1191
Mailing Address - Fax:
Practice Address - Street 1:144 HUNT AVE
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1878
Practice Address - Country:US
Practice Address - Phone:845-499-1191
Practice Address - Fax:845-499-1191
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006128171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty