Healthcare Provider Details

I. General information

NPI: 1164425435
Provider Name (Legal Business Name): JOSEPH CLEMENTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 05/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 HIGHWAY 35
MIDDLETOWN NJ
07748
US

IV. Provider business mailing address

1270 HIGHWAY 35
MIDDLETOWN NJ
07748-2014
US

V. Phone/Fax

Practice location:
  • Phone: 732-615-3900
  • Fax: 732-615-0185
Mailing address:
  • Phone: 732-615-3900
  • Fax: 732-615-0865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA05272000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: