1275676447 NPI number — MRS. KATHLEEN H MACFARLANE PHD

Table of content: MRS. KATHLEEN H MACFARLANE PHD (NPI 1275676447)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275676447 NPI number — MRS. KATHLEEN H MACFARLANE PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACFARLANE
Provider First Name:
KATHLEEN
Provider Middle Name:
H
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHARLTON
Provider Other First Name:
KATHLEEN
Provider Other Middle Name:
H
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1275676447
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
212 LAKEVIEW DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLLINGSWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-858-1050
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 HADDON AVENUE
Provider Second Line Business Practice Location Address:
OUR LADY OF LOURDES HOSPITAL REGIONAL REHABILITATION
Provider Business Practice Location Address City Name:
CAMDEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-757-3973
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  35S100404300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9057005 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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