Basic Information
| Provider Information | |||||||||
| NPI: | 1952732257 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CLEMENTE | ||||||||
| FirstName: | MARIA ROSARIO | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MA, ACNP-BC, ANP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 WORTHINGTON CT | ||||||||
| Address2: | |||||||||
| City: | WEST NYACK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109942830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144552619 | ||||||||
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| Practice Location | |||||||||
| Address1: | 55 PALMER AVE | ||||||||
| Address2: | |||||||||
| City: | BRONXVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107083403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147871000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2013 | ||||||||
| LastUpdateDate: | 12/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 301551 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2200X | F301551-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.