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JAQUELL CLARK
NPI 1407732001
Registered Nurse in Medford, NY

Active since August 12, 2025
97 MAPLE LN, MEDFORD, NY 11763(631) 882-7216 Get Directions Write a Review

NPPES record last updated: August 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jaquell Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAQUELL CLARK (NPI 1407732001) is an individual registered nurse in Medford, New York, licensed in New York (849553) and active in the NPI registry since August 2025.

NPPES Registry Identity

NPI1407732001
Entity TypeIndividualMale
Primary Taxonomy163W00000X
Provider Legal NameJAQUELL CLARK
Location Address97 MAPLE LNMedford, NY 11763-1028
Mailing Address97 Maple LnMedford, NY 11763-1028 · (631) 882-7216
Phone(631) 882-7216
Sole ProprietorYes
Enumeration DateAugust 12, 2025
NPPES CertifiedAugust 12, 2025
✔ NPI 1407732001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
License✔ Licensed in NY · 849553
Definition
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
97 MAPLE LN, Medford, NY 11763
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE JAFFE
Licensed Practical Nurse
97 MAPLE LN
MEDFORD, NY 11763
Suffolk County (631) 948-1731

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaquell Clark's NPI number?

The NPI number for Jaquell Clark is 1407732001. It was assigned to this individual provider in the NPPES registry on August 12, 2025.

Where is Jaquell Clark located?

Jaquell Clark practices at 97 Maple Ln, Medford, NY 11763. The listed phone number is (631) 882-7216.

What is Jaquell Clark's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

When was this NPI record last updated?

The NPPES record for Jaquell Clark was last updated on August 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.