Provider Demographics
NPI:1811258122
Name:CLEMENTE, SANDY TAPUYAO (MD)
Entity type:Individual
Prefix:DR
First Name:SANDY
Middle Name:TAPUYAO
Last Name:CLEMENTE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1910 SASSAFRAS ST
Mailing Address - Street 2:STE 100
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2716
Mailing Address - Country:US
Mailing Address - Phone:814-833-5653
Mailing Address - Fax:814-838-1153
Practice Address - Street 1:3822 COLONIAL AVE STE C
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-3826
Practice Address - Country:US
Practice Address - Phone:814-833-5653
Practice Address - Fax:814-838-1153
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2016-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT201293207Q00000X
PAMD457813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine