Individual
DR. KEVIN CLANCY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
368 LAKEHURST RD, STE 301, TOMS RIVER, NJ 08755-7339
(732) 240-1048
(732) 240-3464
Mailing address
368 LAKEHURST RD, STE 301, TOMS RIVER, NJ 08755-7339
(732) 240-1048
(732) 240-3464
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MA40933
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523201
—
NJ
Enumeration date
06/17/2005
Last updated
07/08/2007
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