Provider Demographics
NPI:1780838516
Name:MCFARLANE, SHELLY
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:
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 1:60 COLUMBIA ST
Mailing Address - Street 2:APT 1 A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-2735
Mailing Address - Country:US
Mailing Address - Phone:646-429-9645
Mailing Address - Fax:
Practice Address - Street 1:60 COLUMBIA ST
Practice Address - Street 2:APT 1 A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-2735
Practice Address - Country:US
Practice Address - Phone:646-429-9645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299139164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse