Provider Demographics
NPI:1386789204
Name:NOLAN, ANN M (PT CHT)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:NOLAN
Suffix:
Gender:F
Credentials:PT CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 CHATHAM CREST DR
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02633-1054
Mailing Address - Country:US
Mailing Address - Phone:914-522-2523
Mailing Address - Fax:
Practice Address - Street 1:9 WEST RD STE 160
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02653-3200
Practice Address - Country:US
Practice Address - Phone:508-255-4181
Practice Address - Fax:508-255-0424
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0090121225100000X
CT004228225100000X
MA25834225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1386789204OtherAETNA, OXFORD
CT3609963OtherAENTA
CTP3088554OtherOXFORD