Provider Demographics
NPI:1972837177
Name:MCCLELLAND, MARY THERESE (ANP)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:THERESE
Last Name:MCCLELLAND
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Gender:F
Credentials:ANP
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 3000
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-731-5210
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-241-6756
Practice Address - Fax:212-423-0522
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2013-04-17
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Provider Licenses
StateLicense IDTaxonomies
NY305261363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health