| Doctor Name: | MS. MARY A HALLECK |
| NPI Number: | 1174565246 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 0229 |
| Business Practice Address: | 212 Calef Hwy Epping, NH - 030422322 |
| Business Phone Number: | 6036932100 |
| Business Fax Number: | |
| Mailing Address: | Po Box 655, EXETER |
| State: | NH |
| Postal Code: | 038330655 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/12/2006 |
| NPI Last Update Date: | 09/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 0229 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |