Basic Information
Provider Information
NPI: 1225474893
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCFARLAND
FirstName: JONATHAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3 FERNWOOD AVE
Address2:  
City: WEST SENECA
State: NY
PostalCode: 14206
CountryCode: US
TelephoneNumber: 7169486764
FaxNumber:  
Practice Location
Address1: 1680 WALDEN AVE
Address2:  
City: CHEEKTOWAGA
State: NY
PostalCode: 142254914
CountryCode: US
TelephoneNumber: 7168947777
FaxNumber: 7168940604
Other Information
ProviderEnumerationDate: 05/22/2013
LastUpdateDate: 05/22/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000X280915NYY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


Home