Individual provider · NPI-1
Caitlin Shelby O'Mara
Specialist/Technologist, Athletic Trainer · East Rockaway, NY
NPI number1205477213
StatusActive
Last updated in NPPESMar 2, 2020
Details
- NPI
- 1205477213
- Entity type
- Individual (NPI-1)
- Name
- Caitlin Shelby O'Mara
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 1, 2019
- Certification date
- Mar 2, 2020
- Last updated
- Mar 2, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | NY | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
27 Woods AveEast Rockaway, NY 11518-1146
Phone 516-474-4687
Mailing address
27 Woods AveEast Rockaway, NY 11518-1146
Phone 516-474-4687
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