Provider Demographics
NPI:1912328469
Name:CLARKE, HELEN MARIA
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:MARIA
Last Name:CLARKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:MARIA
Other - Last Name:DEPRIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 OAKTREE LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1521
Mailing Address - Country:US
Mailing Address - Phone:516-396-9880
Mailing Address - Fax:
Practice Address - Street 1:16 OAKTREE LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1521
Practice Address - Country:US
Practice Address - Phone:516-396-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-31
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY327826-01164W00000X
NY13365861174400000X
NY32826-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No174400000XOther Service ProvidersSpecialist