Provider Demographics
NPI:1194548289
Name:HALLISEY, MARGARET CLARE (LAC, DIPLAC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:CLARE
Last Name:HALLISEY
Suffix:
Gender:F
Credentials:LAC, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 762
Mailing Address - Street 2:
Mailing Address - City:PHILMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12565-0762
Mailing Address - Country:US
Mailing Address - Phone:212-380-8469
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 762
Practice Address - Street 2:
Practice Address - City:PHILMONT
Practice Address - State:NY
Practice Address - Zip Code:12565-0762
Practice Address - Country:US
Practice Address - Phone:212-380-8469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002742-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist