Provider Demographics
NPI:1699720805
Name:CLEMENT, BERNADETTE (MD)
Entity type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HARLEM PEDIATRIC ASSOCIATES
Mailing Address - Street 2:POST OFFICE BOX 1751
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027
Mailing Address - Country:US
Mailing Address - Phone:212-678-5437
Mailing Address - Fax:212-222-6702
Practice Address - Street 1:2235 FREDERICK DOUGLASS BLVD
Practice Address - Street 2:HARLEM PEDIATRIC ASSOCIATES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6175
Practice Address - Country:US
Practice Address - Phone:212-678-5437
Practice Address - Fax:212-222-6702
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2061762080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01919240Medicaid
NY563361Medicare ID - Type Unspecified
NY01919240Medicaid