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General NPI Number Information
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NPI Number | 1124120100
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Entity Type | Individual
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Provider Name | CHRISTINE T. CLANCEY O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 KINGS HWY W
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City | HADDONFIELD
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State | NJ
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Zip | 08033-2126
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Country | US
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Telephone | 856-429-3737
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Fax | 859-429-7030
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Provider Business Mailing Address
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Address Line | 400 KINGS HWY E
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City | HADDONFIELD
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State | NJ
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Zip | 08033-1207
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Country | US
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Telephone | 856-429-4447
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OAOO5658
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License Number State | NJ
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