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General NPI Number Information
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NPI Number | 1144697921
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Entity Type | Individual
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Provider Name | PATRICK KILCARR ATC
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Gender | Male
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 08/27/2015
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Provider Practice Location Address
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Address Line | 2 STEWART PL
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City | EASTCHESTER
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State | NY
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Zip | 10709-5505
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Country | US
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Telephone | 845-825-4899
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Fax |
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Provider Business Mailing Address
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Address Line | 3 OAK LN
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City | NANUET
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State | NY
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Zip | 10954-1823
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Country | US
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Telephone | 845-825-4899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 67002752
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License Number State | NY
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