Provider Demographics
NPI:1912220252
Name:MCFARLANE, LECIA ANDRIA
Entity Type:Individual
Prefix:MISS
First Name:LECIA
Middle Name:ANDRIA
Last Name:MCFARLANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 N CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-4052
Mailing Address - Country:US
Mailing Address - Phone:631-968-2492
Mailing Address - Fax:
Practice Address - Street 1:1419 N CLINTON AVE
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-4052
Practice Address - Country:US
Practice Address - Phone:631-968-2494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293220-1164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse