Organization
CLEMENTE PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SEAN CLEMENTE DPT (CEO)
(646) 404-0014
Entity
Organization
Contact information
Practice address
340 HAVEN AVE APT 2C, NEW YORK, NY 10033-5336
(646) 404-0014
Mailing address
340 HAVEN AVE APT 2C, NEW YORK, NY 10033-5336
(646) 404-0014
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
29331
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11954746
CAQH
NY
Enumeration date
06/02/2014
Last updated
06/02/2014
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