Provider Demographics
NPI:1609931153
Name:MCFARLANE, JACQUELINE P (MD)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:P
Last Name:MCFARLANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 MARY ST
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-2752
Mailing Address - Country:US
Mailing Address - Phone:570-460-8373
Mailing Address - Fax:
Practice Address - Street 1:GREYSTONE PARK PSYCHIATRIC HOSPITAL
Practice Address - Street 2:1 CENTRAL AVENUE
Practice Address - City:GREYSTONE PARK
Practice Address - State:NJ
Practice Address - Zip Code:09750
Practice Address - Country:US
Practice Address - Phone:973-538-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA066571002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG58470Medicare UPIN
NJMC051321Medicare ID - Type Unspecified