Provider Demographics
NPI:1194741769
Name:MCLEAN, ESMINE MARCIA (RN)
Entity type:Individual
Prefix:MISS
First Name:ESMINE
Middle Name:MARCIA
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 RADCLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-3717
Mailing Address - Country:US
Mailing Address - Phone:718-655-5062
Mailing Address - Fax:
Practice Address - Street 1:16 WESTCHESTER SQ
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3513
Practice Address - Country:US
Practice Address - Phone:718-822-1217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY551567163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)