Provider Demographics
NPI:1508207515
Name:ALLAMBY, CLEMENTE
Entity Type:Individual
Prefix:MR
First Name:CLEMENTE
Middle Name:
Last Name:ALLAMBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MAYBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-2448
Mailing Address - Country:US
Mailing Address - Phone:732-236-1672
Mailing Address - Fax:
Practice Address - Street 1:37 MAYBERRY AVE
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-2448
Practice Address - Country:US
Practice Address - Phone:732-236-1672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00028100225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist