Provider Demographics
NPI:1316175169
Name:ZACCA-MCFARLANE, MARCELLINE ALECIA (PHARMD)
Entity type:Individual
Prefix:
First Name:MARCELLINE
Middle Name:ALECIA
Last Name:ZACCA-MCFARLANE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 ROBERT ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-3927
Mailing Address - Country:US
Mailing Address - Phone:718-737-4066
Mailing Address - Fax:
Practice Address - Street 1:215 CHARLES ST
Practice Address - Street 2:UNIT #111
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-5622
Practice Address - Country:US
Practice Address - Phone:718-737-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CTPCT.0011357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program