Lake, Clifton Rudolph
Lake, Clifton Rudolph is an sole proprietor health care provider with primary practice located at 46 Brook Rd , Valley Stream NY 11581-2416. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Hospitals / Psychiatric Hospital. Hospitals / Psychiatric Hospital is his primary health care specialty. Lake, Clifton Rudolph can be contacted via phone (516) 508-0128.Contact Information
Primary practice address
46 Brook Rd
Valley Stream NY 11581-2416
Phone: (516) 508-0128
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ACN1119 | Florida |
Hospitals / Psychiatric Hospital | 283Q00000X | P60621 | New York |
Profile Details
NPI number | 1063698330 |
---|---|
LBN Legal business name | Lake, Clifton Rudolph |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 16th, 2008 |
Last updated | May 20th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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