Patrick T Clancy, MD, PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

25MA04814800 Issued in NJ

Legal business name

PATRICK T CLANCY, MD, PA

Practice address

44 Godwin Ave
Suite 101
Midland Park, NJ 07432-1969

Phone

(201) 447-5454

Fax

(201) 447-8922

NPI assigned

Sep 26, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patrick T Clancy, MDNPI 1740381128

Title

MD/Owner

Phone

(201) 447-5454

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patrick T Clancy, MD

  • Ophthalmology Physician
  • Midland Park, NJ
  • NPI 1740381128
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1124129440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 GODWIN AVE",
            "address_2": "SUITE 101",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321969",
            "telephone_number": "201-447-5454",
            "fax_number": "201-447-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 GODWIN AVE",
            "address_2": "SUITE 101",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321969",
            "telephone_number": "201-447-5454",
            "fax_number": "201-447-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK T CLANCY, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "CLANCY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "201-447-5454",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA04814800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nermeen Elsaid Gamal Othman
• Elizabeth Anne Panissidi, LCSW
• Kathryn Pare, MS, RD
• Peter Pastras, LCSW
• Patrick Clancy MD, PA
• Jessica Peacock, L.C.S.W.
• Pediatric Dentistry & Orthodontics, LLC
• Pediatric Dentistry and Orthodontics Center LLC
• Benjamin Daniel Perlman
• Michelle Danielle Peterson, LPC

• Ophthalmology Physician in Midland Park, NJ
• Providers in Midland Park, NJ by specialty
• Ophthalmology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.