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General NPI Number Information
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NPI Number | 1184746570
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Entity Type | Organization
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Legal Business Name | CHRISTINE T. CLANCEY, O.D., L.L.C
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 421 S EGG HARBOR RD
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City | HAMMONTON
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State | NJ
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Zip | 08037-1417
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Country | US
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Telephone | 609-567-2586
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Fax | 609-567-7811
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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 | PRESIDENT
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Name | DR. CHRISTINE T CLANCEY
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Credential | O.D.
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Telephone | 856-429-4447
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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 | OA005658
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License Number State | NJ
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