Provider Demographics
NPI:1861796674
Name:MC ERLEAN, AOIFE MARY (MB BCH BAO)
Entity type:Individual
Prefix:DR
First Name:AOIFE
Middle Name:MARY
Last Name:MC ERLEAN
Suffix:
Gender:F
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 YORK AVE
Mailing Address - Street 2:APT 17L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6306
Mailing Address - Country:US
Mailing Address - Phone:917-855-6092
Mailing Address - Fax:
Practice Address - Street 1:1233 YORK AVE
Practice Address - Street 2:APT 17L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6306
Practice Address - Country:US
Practice Address - Phone:917-855-6092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-08
Last Update Date:2011-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP75242390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program