National Provider Identifier Database

CLYDE A PEMBERTON, MD – NPI #1629225594
Addiction Medicine

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine


Contact Information

CLYDE A PEMBERTON, MD
15 S 9TH ST
NEWARK, NJ07107-2147
Phone: 973-497-9360
Fax: 973-497-9100
Website:
Specialty Taxonomy Code
* Addiction Medicine 2084A0401X

* Indicates primary specialty

NPI Profile & details for CLYDE A PEMBERTON

NPI Number 1629225594
Credentials MD
Entity Individual
Enumeration date 08/22/2008
Last updated 08/22/2008 - About 18 years ago
Sole proprietor1 Yes
Identifiers
  • NJ License #: 47443
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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