Provider Demographics
NPI:1003081332
Name:MCPARTLAN, THERESA (LAC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:MCPARTLAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 RIDGE BLVD
Mailing Address - Street 2:APT 4H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4329
Mailing Address - Country:US
Mailing Address - Phone:347-633-6333
Mailing Address - Fax:
Practice Address - Street 1:427 77TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3205
Practice Address - Country:US
Practice Address - Phone:347-633-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003865171100000X
NY299436163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse