Provider Demographics
NPI:1073575361
Name:CLAMAN, MARLENE A (PA)
Entity Type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:A
Last Name:CLAMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:120 S TAN ALY STE 1
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17026-9349
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 S. TAN STREET, SUITE 1
Practice Address - Street 2:FREDERICKSBURG COMMUNITY HEALTH CENTER PC
Practice Address - City:FREDERICKSBURG
Practice Address - State:PA
Practice Address - Zip Code:17026-0009
Practice Address - Country:US
Practice Address - Phone:717-865-6644
Practice Address - Fax:717-865-7321
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA002121L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA022863HE2Medicare PIN
S70399Medicare UPIN