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Individual

DR. CLEMENT A. MACCIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
65 MOUNTIAN BLVD., SUITE 107, WARREN, NJ 07059-5678
(732) 627-0900
(732) 560-7388
Mailing address
65 MOUNTIAN BLVD., SUITE 107, WARREN, NJ 07059-5678
(732) 627-0900
(732) 560-7388

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
MA02833300
NJ
207K00000X
Allergy & Immunology Physician
Primary
25MA02833300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01101136
AMERIGROUP
NJ
01
0924679
CIGNA, GREATWEST
NJ
01
1211058
WELLCARE
NJ
05
1555201
NJ
01
1568431351
QUALCARE PPO/HMO
NJ
01
2985900
UHC COMMUNITY PLAN
NJ
01
4238239
AETNA PPO
NJ
01
5595926
AETNA HMO
NJ
01
7N1821
EMPIRE BC
NJ
01
P5392984
OXFORD
NJ
Enumeration date
03/15/2006
Last updated
11/15/2021
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