Provider Demographics
NPI:1063888410
Name:HALLISSEY, KATE (CPNP)
Entity type:Individual
Prefix:MS
First Name:KATE
Middle Name:
Last Name:HALLISSEY
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Gender:F
Credentials:CPNP
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Mailing Address - Street 1:1 PARK ST
Mailing Address - Street 2:PEDIATRIC HEMATOLOGY/ONCOLOGY
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06504-8901
Mailing Address - Country:US
Mailing Address - Phone:203-785-4640
Mailing Address - Fax:203-737-2228
Practice Address - Street 1:5520 PARK AVENUE
Practice Address - Street 2:PEDIATRIC HEMATOLOGY AND ONCOLOGY
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-3463
Practice Address - Country:US
Practice Address - Phone:203-785-4640
Practice Address - Fax:203-737-2228
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2021-08-03
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Provider Licenses
StateLicense IDTaxonomies
NYF382554363LP0200X
CT9461363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics