Provider Demographics
NPI:1295941466
Name:CLEMENS, MARY ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:CLEMENS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:30 SAYBROOK PL
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-1107
Mailing Address - Country:US
Mailing Address - Phone:716-881-2560
Mailing Address - Fax:716-881-2560
Practice Address - Street 1:3622 WENDE RD
Practice Address - Street 2:MEDICAL DIRECTOR WENDE RMU
Practice Address - City:ALDEN
Practice Address - State:NY
Practice Address - Zip Code:14004-1187
Practice Address - Country:US
Practice Address - Phone:716-937-4000
Practice Address - Fax:716-937-4244
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY110341-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine