Provider Demographics
NPI:1205437423
Name:CLEMENT, CHRISTINE (RD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 W 76TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-8045
Mailing Address - Country:US
Mailing Address - Phone:774-279-0430
Mailing Address - Fax:
Practice Address - Street 1:319 W 76TH ST APT 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-8045
Practice Address - Country:US
Practice Address - Phone:774-279-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered