Provider Demographics
NPI:1801823042
Name:HALEY, MICHAEL G (PHYSICAL THERPIST MS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:G
Last Name:HALEY
Suffix:
Gender:M
Credentials:PHYSICAL THERPIST MS
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Mailing Address - Street 1:ONE GARNETT LANE
Mailing Address - Street 2:NORTHERN RI PHYSICAL THERAPY STE 3
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-1414
Mailing Address - Country:US
Mailing Address - Phone:401-949-0380
Mailing Address - Fax:401-949-5581
Practice Address - Street 1:ONE GARNETT LANE
Practice Address - Street 2:NORTHERN RI PHYSICAL THERAPY STE 3
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-1414
Practice Address - Country:US
Practice Address - Phone:401-949-0380
Practice Address - Fax:401-949-5581
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2011-09-22
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Provider Licenses
StateLicense IDTaxonomies
RIPT01150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
402508OtherRI BLUE CHIP
411376OtherRI BLUE CHIP
402512OtherRI BLUE CHIP
007010144OtherUPIN FED MEDICARE
007056176OtherUPIN FED MEDICARE
26679OtherRI NEIGHBORHOOD PIN
RI75277OtherRI BLUE CROSS
RI402381OtherRI BLUE CHIP
6400148OtherUNITED HEALTH NE
410188OtherRI BLUE CHIP
007001716OtherUPIN FED MEDICARE
8225OtherRI NEIGHBORHOOD PIN GROUP
007001715OtherUPIN FED MEDICARE
26679OtherRI NEIGHBORHOOD PIN
411376OtherRI BLUE CHIP