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General NPI Number Information
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NPI Number | 1194741769
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Entity Type | Individual
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Provider Name | ESMINE MARCIA MCLEAN RN
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Gender | Female
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 16 WESTCHESTER SQ
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City | BRONX
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State | NY
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Zip | 10461-3513
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Country | US
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Telephone | 718-822-1217
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Fax |
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Provider Business Mailing Address
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Address Line | 3315 RADCLIFF AVE
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City | BRONX
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State | NY
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Zip | 10469-3717
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Country | US
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Telephone | 718-655-5062
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 551567
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License Number State | NY
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