=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528459013
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALISON MCCARTHY ATC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2015
-----------------------------------------------------
Last Update Date | 06/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35 DAVID RD
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06422-2601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-853-7839
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35 DAVID RD
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06422-2601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-853-7839
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2255A2300X
-----------------------------------------------------
Taxonomy Name | Athletic Trainer
-----------------------------------------------------
License Number | RT005607
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------