Locke, Clyde

Locke, Clyde is an sole proprietor health care provider with primary practice located at 3804 28Th Avenue , Astoria NY 11103-3313. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Locke, Clyde can be contacted via phone (718) 278-3800.

Contact Information

Primary practice address
3804 28Th Avenue Astoria NY 11103-3313
Fax: (718) 278-3318
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 093260 New York

Profile Details

NPI number 1497897540
LBN Legal business name Locke, Clyde
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2007
Last updated Jul 8th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1497897540 NPPES
New York MEDICAID 01425727

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