Provider Demographics
NPI:1932847621
Name:OCALLAGHAN, MARIA (LMT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:OCALLAGHAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FLANDERS RD
Mailing Address - Street 2:
Mailing Address - City:STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06378-2414
Mailing Address - Country:US
Mailing Address - Phone:917-723-0921
Mailing Address - Fax:
Practice Address - Street 1:180 FLANDERS RD
Practice Address - Street 2:
Practice Address - City:STONINGTON
Practice Address - State:CT
Practice Address - Zip Code:06378-2414
Practice Address - Country:US
Practice Address - Phone:917-723-0921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017537225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist