Provider Demographics
NPI:1467632315
Name:CLEMENT L TREMPE MD PC
Entity type:Organization
Organization Name:CLEMENT L TREMPE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR CLINIC & BUSINESS OPS
Authorized Official - Prefix:MS
Authorized Official - First Name:ZENA
Authorized Official - Middle Name:F
Authorized Official - Last Name:NIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-262-2020
Mailing Address - Street 1:218 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:NAHANT
Mailing Address - State:MA
Mailing Address - Zip Code:01908-1058
Mailing Address - Country:US
Mailing Address - Phone:781-595-1630
Mailing Address - Fax:781-599-1563
Practice Address - Street 1:930 COMMONWEALTH AVE NEW ENGLAND EYE INSTITUTE
Practice Address - Street 2:SUITE 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-262-2020
Practice Address - Fax:617-587-5518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37124207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM13124OtherBCBS MA
MA705430OtherTUFTS HEALTH PLAN
MAM13124OtherBCBS MA
MAM13124Medicare PIN