Provider Demographics
NPI:1467416339
Name:CLINCH, MAUREEN SUZANNE (DPM)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:SUZANNE
Last Name:CLINCH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:609-267-9400
Mailing Address - Fax:856-234-3921
Practice Address - Street 1:300 W ROUTE 38 STE A
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3424
Practice Address - Country:US
Practice Address - Phone:609-267-9400
Practice Address - Fax:856-234-3921
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00284900213ES0103X
PASC005610213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ097794MNWMedicare PIN
PAV07591Medicare UPIN
PA096558MNAMedicare PIN
NJ097794MNCMedicare PIN