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NPI Code Detail

MEDICARE: KEVIN THOMAS CLEMENTS

MEDICARE: KEVIN THOMAS CLEMENTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician343205NY

General Provider Information

NPI Number : 1568091775
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN THOMAS CLEMENTS
Provider Business Mailing Address
First Line : 4802 10TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2916
Country : US
Telephone Number : 718-283-6000
Fax Number :
Provider Business Practice Location Address
First Line : 4802 10TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2916
Country : US
Telephone Number : 718-283-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2020
Last Update Date : 05/11/2026

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Directions to “ KEVIN THOMAS CLEMENTS ” Practice Location

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