Provider Demographics
NPI:1053947861
Name:CLOTAIRE, NORMA
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:CLOTAIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 LOWER STATE RD APT 6B5
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-2141
Mailing Address - Country:US
Mailing Address - Phone:267-240-7246
Mailing Address - Fax:
Practice Address - Street 1:700 LOWER STATE RD APT 6B5
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2141
Practice Address - Country:US
Practice Address - Phone:267-240-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health