Individual provider Active NPI

Ellen Mary McLean, LCAT

  • Medical Art Specialist/Technologist
  • Bronx, NY
National Provider Identifier
1013154079
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Art Specialist/TechnologistTaxonomy code 246ZA2600X
License
000704 Issued in NY
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

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
000704NYMDNeurology 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.

Verify at the official NPI Registry.