Provider Demographics
NPI:1801363015
Name:CLEMENTE, MOLLY (PA-C)
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:
Last Name:CLEMENTE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 PARK ST
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1498
Mailing Address - Country:US
Mailing Address - Phone:570-253-8100
Mailing Address - Fax:
Practice Address - Street 1:712 E DRINKER ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-2508
Practice Address - Country:US
Practice Address - Phone:215-837-5490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant