Provider Demographics
NPI:1871742106
Name:HOLYOKE, CAROL (MSPT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:HOLYOKE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MAGAW PL APT 6A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-5250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 W 41ST ST
Practice Address - Street 2:SUITE 1807
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-7207
Practice Address - Country:US
Practice Address - Phone:212-997-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020494-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic