Healthcare Provider Details

I. General information

NPI: 1962329391
Provider Name (Legal Business Name): PATRICK MCHALE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 VAUXHALL ST
NEW LONDON CT
06320-5723
US

IV. Provider business mailing address

9 RIDGE RD
GROTON CT
06340-8927
US

V. Phone/Fax

Practice location:
  • Phone: 860-442-4363
  • Fax:
Mailing address:
  • Phone: 571-289-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number006952
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: