Healthcare Provider Details

I. General information

NPI: 1417253519
Provider Name (Legal Business Name): RICHARD HOLLIGAN PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2011
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 ATLANTIC CITY BLVD
BAYVILLE NJ
08721-1229
US

IV. Provider business mailing address

160 ATLANTIC CITY BLVD
BAYVILLE NJ
08721-1229
US

V. Phone/Fax

Practice location:
  • Phone: 732-349-5550
  • Fax: 732-349-0841
Mailing address:
  • Phone: 732-349-5550
  • Fax: 732-349-0841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN50008
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15088000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: