Provider Demographics
NPI:1770386450
Name:CLEMENTE, CARLO JOSE
Entity type:Individual
Prefix:MR
First Name:CARLO
Middle Name:JOSE
Last Name:CLEMENTE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 ARCH ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-7327
Mailing Address - Country:US
Mailing Address - Phone:347-290-0127
Mailing Address - Fax:347-290-0127
Practice Address - Street 1:2929 ARCH ST STE 1700
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-7327
Practice Address - Country:US
Practice Address - Phone:917-254-6404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide