Healthcare Provider Details

I. General information

NPI: 1588305072
Provider Name (Legal Business Name): MATTHEW COLIN MCLEAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 STATE ROUTE 33
NEPTUNE NJ
07753-4859
US

IV. Provider business mailing address

62 LINCOLN AVE
CLIFFSIDE PARK NJ
07010-3038
US

V. Phone/Fax

Practice location:
  • Phone: 732-775-5500
  • Fax:
Mailing address:
  • Phone: 201-283-2078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA13151800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: