NPI 1063698330

Clifton Rudolph Lake, MD

Practitioner Psychiatric Hospital Valley Stream, NY

Practice location

Address: 46 Brook Rd, Valley Stream, NY 11581-2416
Phone: (516) 508-0128

Registered specialties (2)

Psychiatric Hospital Primary

Hospitals Taxonomy 283Q00000X Licence P60621 (NY)

Other Psychiatric Hospital providers in New York →

Psychiatry Physician

Allopathic & Osteopathic Physicians Taxonomy 2084P0800X Licence ACN1119 (FL)

Other Psychiatry & Neurology providers in New York →

Registry record

NPI: 1063698330
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jan 2008
Record last updated: 20 May 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.