Provider Demographics
NPI:1053628685
Name:FENTON-MCHALE, CAROL ANN (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:FENTON-MCHALE
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2732
Mailing Address - Country:US
Mailing Address - Phone:914-287-0088
Mailing Address - Fax:
Practice Address - Street 1:127 S. BROADWAY
Practice Address - Street 2:ST. JOSEPH'S MED. CENTER, SBP, STEIN CENTER
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4080
Practice Address - Country:US
Practice Address - Phone:914-378-7573
Practice Address - Fax:914-378-7453
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004055-1225XE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification