Provider Demographics
NPI:1720102932
Name:MCNALLY, KATHLEEN HURLEY (PT,DPT,MS)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:HURLEY
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:PT,DPT,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2942 210TH PL
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2433
Mailing Address - Country:US
Mailing Address - Phone:718-229-5562
Mailing Address - Fax:
Practice Address - Street 1:2942 210TH PL
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2433
Practice Address - Country:US
Practice Address - Phone:917-561-8805
Practice Address - Fax:718-229-5562
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004888-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist