Provider Demographics
NPI:1417100561
Name:OHALLORAN, LAURALYNN (PT)
Entity Type:Individual
Prefix:
First Name:LAURALYNN
Middle Name:
Last Name:OHALLORAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 BROADWAY APT 15
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2848
Mailing Address - Country:US
Mailing Address - Phone:914-815-0127
Mailing Address - Fax:914-693-0406
Practice Address - Street 1:152 BROADWAY APT 15
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2848
Practice Address - Country:US
Practice Address - Phone:914-815-0127
Practice Address - Fax:914-693-0406
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-02
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009689-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics