Healthcare Provider Details

I. General information

NPI: 1598988321
Provider Name (Legal Business Name): LINDA L MCHALE CPM, EMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 CENTRAL AVE
LAKEWOOD NJ
08701-3001
US

IV. Provider business mailing address

1210 CENTRAL AVE
LAKEWOOD NJ
08701-3001
US

V. Phone/Fax

Practice location:
  • Phone: 732-730-0578
  • Fax: 732-730-0579
Mailing address:
  • Phone: 732-730-0578
  • Fax: 732-730-0579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number95040003
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: