Individual
DR. RODERICK JOHN CLEMENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
96 GATES AVENUE, MONTCLAIR, NJ 07042
(973) 744-3166
(973) 744-3199
Mailing address
96 GATES AVE, MONTCLAIR, NJ 07042-2501
(973) 744-3166
(973) 744-3199
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
25MA04150100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582676791
TAX ID#
NJ
Enumeration date
10/03/2006
Last updated
06/23/2010
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