Patrick Clancy MD, PA

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

25MA04814800 Issued in NJ

Legal business name

PATRICK 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

Feb 1, 2007

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, MD

Title

Owner

Phone

(201) 447-5454

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1861530065",
    "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 CLANCY MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "CLANCY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-447-5454",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NJ",
            "license": "25MA04814800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgette Randy Oosting, FNP
• Nermeen Elsaid Gamal Othman
• Elizabeth Anne Panissidi, LCSW
• Kathryn Pare, MS, RD
• Peter Pastras, LCSW
• Patrick T Clancy, MD, PA
• Jessica Peacock, L.C.S.W.
• Pediatric Dentistry & Orthodontics, LLC (Pediatric Dentistry of Midland Park)
• Pediatric Dentistry and Orthodontics Center LLC
• Benjamin Daniel Perlman

• Eyewear Supplier in Midland Park, NJ
• Providers in Midland Park, NJ by specialty
• Eyewear Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.