Provider Demographics
NPI:1558601104
Name:MCLEAN, RENEE CHRISTINE (MSED)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:CHRISTINE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HEARTLAND DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-6015
Mailing Address - Country:US
Mailing Address - Phone:518-369-1432
Mailing Address - Fax:
Practice Address - Street 1:101 HEARTLAND DR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-6015
Practice Address - Country:US
Practice Address - Phone:518-369-1432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382259031174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist