Provider Demographics
NPI:1649465865
Name:HALLOWELL, MARGARET NOLAN (PA)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:NOLAN
Last Name:HALLOWELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:MARY
Other - Last Name:NOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:100 HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772
Mailing Address - Country:US
Mailing Address - Phone:631-475-6900
Mailing Address - Fax:631-447-5954
Practice Address - Street 1:100 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-475-6900
Practice Address - Fax:631-447-5954
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3052-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical