Provider Demographics
NPI:1528833472
Name:CLARKE-CARRINGTON, DIONNE M
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:M
Last Name:CLARKE-CARRINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 BROOKHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-2017
Mailing Address - Country:US
Mailing Address - Phone:347-300-2813
Mailing Address - Fax:
Practice Address - Street 1:2522 BROOKHAVEN AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-2017
Practice Address - Country:US
Practice Address - Phone:347-300-2813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator