Individual
ALICE O'HALLORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8901 KENNEDY BLVD, NORTH BERGEN, NJ 07047-5344
(201) 854-6700
(201) 854-6779
Mailing address
11 EAGLE ROCK AVE, FL 2, EAST HANOVER, NJ 07936-3167
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00983900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5505370
GUARDIAN
NJ
01
—
NL7012
HEALTHNET
NJ
Enumeration date
10/19/2006
Last updated
03/28/2019
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