Active NPI
Ellen Mary McLean, LCAT
- Medical Art Specialist/Technologist
- Bronx, NY
National Provider Identifier
1013154079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Art Specialist/Technologist
- License
- 000704
- Practice address
- 4419 3Rd Ave
Bronx, NY 10457-2562 - Phone
- (718) 364-7700
- Fax
- (718) 364-7700
- NPI assigned
- Jan 13, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | 000704 | NY | |
| Medical Art Specialist/Technologist | 246ZA2600X | 000704 | NY | Primary |
Addresses
Primary practice location
4419 3Rd Ave
Bronx, NY 10457-2562
Mailing address
147 New Holland VLG
Nanuet, NY 10954-2444
Phone (845) 623-1961
Other practice location 1
406 E 176th St
Bronx, NY 10457-6003
Phone (718) 901-6810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000704 | NY | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1013154079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 NEW HOLLAND VLG",
"city": "NANUET",
"state": "NY",
"postal_code": "109542444",
"telephone_number": "845-623-1961",
"fax_number": "718-901-6880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4419 3RD AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104572562",
"telephone_number": "718-364-7700",
"fax_number": "718-364-7700"
}
],
"practiceLocations": [
{
"address_1": "406 E 176th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104576003",
"country_code": "US",
"telephone_number": "718-901-6810",
"fax_number": "718-901-6880",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCLEAN",
"first_name": "ELLEN",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "LCAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-13",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "NY",
"license": "000704",
"primary": false
},
{
"code": "246ZA2600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Art, Medical",
"state": "NY",
"license": "000704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.