MEDICARE: MS. KIM MARIE HALLINAN NP

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	F332371	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P3142255	OTHER	NY	OXFORD HEALTH PLAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982673109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIM MARIE HALLINAN NP

Provider Business Mailing Address
First Line	:	40 ROCKFORD DR
Second Line	:
City	:	WEST NYACK
State	:	NY
Zip	:	10994-1122
Country	:	US
Telephone Number	:	845-623-1119
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 SANATORIUM RD
Second Line	:	BUILDING D
City	:	POMONA
State	:	NY
Zip	:	10970-3555
Country	:	US
Telephone Number	:	845-364-2531
Fax Number	:

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	02/03/2010

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