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NPI 1275149411

NPI 1275149411 : HOLLY CHRISTINE MCHALE ATC : MELVILLE, NY

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General NPI Number Information
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    NPI Number           |    1275149411
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    Entity Type          |    Individual 
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    Provider Name        |    HOLLY CHRISTINE MCHALE ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/22/2020
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    Last Update Date     |    09/22/2020
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Provider Practice Location Address
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    Address Line         |    350 S SERVICE RD 
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    City                 |    MELVILLE
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    State                |    NY
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    Zip                  |    11747-3233
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    Country              |    US
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    Telephone            |    631-662-6355
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2417 JERICHO TPKE # 268 
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    City                 |    GARDEN CITY PARK
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    State                |    NY
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    Zip                  |    11040-4710
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    Country              |    US
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    Telephone            |    631-662-6355
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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       |    003078
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    License Number State |    NY
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