Healthcare Provider Details

I. General information

NPI: 1881075232
Provider Name (Legal Business Name): CELIA MCCLELLAND HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W MAIN ST
FREEHOLD NJ
07728-2524
US

IV. Provider business mailing address

320 W MAIN ST
FREEHOLD NJ
07728-2524
US

V. Phone/Fax

Practice location:
  • Phone: 732-780-3087
  • Fax:
Mailing address:
  • Phone: 732-780-3087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number25MG00113300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: