Individual
KYLE T. HALLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-1975
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
283088
MA
207RP1001X
Pulmonary Disease Physician
Primary
283088
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110127819A
—
MA
Enumeration date
06/18/2014
Last updated
07/03/2024
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