Individual
PAULA L CLINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DTR
Contact information
Practice address
701 NEWARK AVE, ELIZABETH, NJ 07208-3550
(908) 346-0269
Mailing address
111 BERMUDA DR, BRANCHBURG, NJ 08853-4286
(908) 336-0372
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105846
AMERIGROUP PROVIDER #
NJ
Enumeration date
11/07/2006
Last updated
07/08/2007
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