Provider Demographics
NPI:1437273216
Name:CLAY, LEE S (CNM)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:S
Last Name:CLAY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 HANCE RD
Mailing Address - Street 2:
Mailing Address - City:FAIR HAVEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07704-3210
Mailing Address - Country:US
Mailing Address - Phone:732-224-0344
Mailing Address - Fax:
Practice Address - Street 1:34 SYCAMORE AVE
Practice Address - Street 2:2A
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1228
Practice Address - Country:US
Practice Address - Phone:732-747-9310
Practice Address - Fax:732-747-9320
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00007000367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife