Provider Demographics
NPI:1184653446
Name:MCLARNON, CECILLE (PT)
Entity Type:Individual
Prefix:
First Name:CECILLE
Middle Name:
Last Name:MCLARNON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 LIBERTY ST APT 8
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-1768
Mailing Address - Country:US
Mailing Address - Phone:201-233-7839
Mailing Address - Fax:
Practice Address - Street 1:156 LIBERTY ST APT 8
Practice Address - Street 2:
Practice Address - City:LITTLE FERRY
Practice Address - State:NJ
Practice Address - Zip Code:07643-1768
Practice Address - Country:US
Practice Address - Phone:201-233-7839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01156300225100000X
NY027994225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist