NPI 1467014894

Crystal Clark

Practitioner Adult Companion Rochester, NY

Practice location

Address: 153 Brambury Dr APT D, Rochester, NY 14621-1820
Phone: (404) 621-2852
Mailing address: PO Box 64283, Rochester, NY 14624-6683

Registered specialties (3)

Adult Companion Primary

Nursing Service Related Providers Taxonomy 372600000X

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Nurse's Aide

Nursing Service Related Providers Taxonomy 376K00000X Licence NYGA0401903R (NY)

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Chore Provider

Nursing Service Related Providers Taxonomy 372500000X

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Registry record

NPI: 1467014894
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Jul 2019
Record last updated: 6 Jul 2019

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.