Provider Demographics
NPI:1477053627
Name:MACFARLANE, KEITH (HIS)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:
Last Name:MACFARLANE
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 SCHANCK RD STE C-5
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3073
Mailing Address - Country:US
Mailing Address - Phone:732-462-1413
Mailing Address - Fax:
Practice Address - Street 1:57 SCHANCK RD STE C-5
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3073
Practice Address - Country:US
Practice Address - Phone:732-462-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist