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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 Specialty Code Provider Type

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for CLYDE A PEMBERTON · (Male)

NPI # 1629225594
Status Active
Credentials MD
Entity Individual
Enumeration date 08/22/2008
Last updated 08/22/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 47443
Hospital affiliation(s) Not Available
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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