Provider Demographics
NPI:1235027533
Name:OCALLAGHAN, MOLLY BYRNE
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:BYRNE
Last Name:OCALLAGHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 SHRINE RD
Mailing Address - Street 2:
Mailing Address - City:FULTONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12072-1907
Mailing Address - Country:US
Mailing Address - Phone:845-594-1675
Mailing Address - Fax:
Practice Address - Street 1:144 SHRINE RD
Practice Address - Street 2:
Practice Address - City:FULTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12072-1907
Practice Address - Country:US
Practice Address - Phone:845-594-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME6966225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist