Individual
DR. JESSICA KATHLEEN MCLANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
111 CENTRAL AVENUE, NEWARK, NJ 07102
(570) 510-5752
Mailing address
111 CENTRAL AVENUE, NEWARK, NJ 07102
(570) 510-5752
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB09016500
NJ
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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