MEDICARE: CATHARINE HALPIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1851785166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHARINE HALPIN

Provider Business Mailing Address
First Line	:	77 CHILD HILL RD
Second Line	:
City	:	WOODSTOCK
State	:	CT
Zip	:	06281-2315
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 ALLIED DR
Second Line	:
City	:	DEDHAM
State	:	MA
Zip	:	02026-6146
Country	:	US
Telephone Number	:	860-670-5971
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	03/25/2015

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