| Doctor Name: | MRS. CARLY MARIE WHOLLEY |
| NPI Number: | 1063860872 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | F339574-1 |
| Business Practice Address: | 1 Garrett Pl Apt 4h Bronxville, NY - 10708 |
| Business Phone Number: | 8603028816 |
| Business Fax Number: | |
| Mailing Address: | 1 Garrett Pl, Apt 4h BRONXVILLE |
| State: | NY |
| Postal Code: | 107082951 |
| Phone Number: | 8603028816 |
| Fax Number: | |
| NPI Enumeration Date: | 06/02/2016 |
| NPI Last Update Date: | 06/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F339574-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |