Provider Demographics
NPI:1942263611
Name:CALLAGHAN, MARGARET MARY (MS,ATC)
Entity Type:Individual
Prefix:MISS
First Name:MARGARET
Middle Name:MARY
Last Name:CALLAGHAN
Suffix:
Gender:F
Credentials:MS,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 NORTHRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:N MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1928
Mailing Address - Country:US
Mailing Address - Phone:516-623-4456
Mailing Address - Fax:
Practice Address - Street 1:64 NORTHRIDGE AVE
Practice Address - Street 2:
Practice Address - City:N. MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566
Practice Address - Country:US
Practice Address - Phone:516-623-4456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000161-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer