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General NPI Number Information
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NPI Number | 1730482928
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Entity Type | Individual
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Provider Name | RICHARD HEBREZA CLEMENTE ACNP
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Gender | Male
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Dates
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Enumeration Date | 12/10/2010
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 530 FIRST AVENUE, HCC 13 NYU LANGONE MEDICAL CENTER
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City | NEW YORK
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State | NY
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Zip | 10016-1753
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Country | US
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Telephone | 347-346-2560
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Fax |
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Provider Business Mailing Address
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Address Line | 2145 44TH DR APT 1B
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-4750
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Country | US
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Telephone | 917-456-2393
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 520383
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | F430528-1
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License Number State | NY
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