MEDICARE: PATRICIA HALO F.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	334278	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A400007918	OTHER	NY	MEDICARE PTAN

General Provider Information

NPI Number	:	1447315890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA HALO F.N.P.

Provider Business Mailing Address
First Line	:	337 N MAIN ST
Second Line	:	SUITE 6
City	:	NEW CITY
State	:	NY
Zip	:	10956-4310
Country	:	US
Telephone Number	:	845-638-0923
Fax Number	:	845-638-6665

Provider Business Practice Location Address
First Line	:	337 N MAIN ST
Second Line	:	SUITE 6
City	:	NEW CITY
State	:	NY
Zip	:	10956-4310
Country	:	US
Telephone Number	:	845-638-0923
Fax Number	:	845-638-6665

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	08/13/2010

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Directions to “ PATRICIA HALO F.N.P.” Practice Location

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