Individual
MR. DOUGLAS A HALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2700 WESTCHESTER AVE STE 300, PURCHASE, NY 10577-2554
(914) 323-2868
Mailing address
46 PETERSON CT, PEARL RIVER, NY 10965-2865
(845) 558-0185
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010228
NY
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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