Ma Ivy Clemente

Primary specialty

Pathology Specialist/TechnologistTaxonomy code 246Q00000X

License

2061-C Issued in AS

Practice address

PO Box LBJ
Pago Pago, AS 96799-0010

Phone

(684) 633-1222

Fax

(684) 633-2893

NPI assigned

Aug 28, 2013

Last updated

Aug 28, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1487088217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX LBJ",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967990010",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX LBJ",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967990010",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "MA IVY",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Q00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology",
            "state": "AS",
            "license": "2061-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charity Geriatric and Wound Care Medical Center
• Labh Kumar Chaurasiya, MD
• Frangel Chipongian, MD
• Dexter Thomas Chute, MBBS
• Luisa Clemens, PHARMD
• Efigenia Conanan-Jimenez, MD
• Sharon Dakuitoga, MBBS
• Naomi Milay Dane, MD
• Concordio Jr Baldrez De Quiroz
• Department of Search and Rescue (Sar)

• Pathology Specialist/Technologist in Pago Pago, AS
• Providers in Pago Pago, AS by specialty
• Pathology Specialist/Technologist in American Samoa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.