Provider Demographics
NPI:1013418185
Name:HALEPAS, STEVEN G JR (MD, DMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:HALEPAS
Suffix:JR
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:860-269-5604
Mailing Address - Fax:831-244-9069
Practice Address - Street 1:622 W 168TH ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:332-201-1856
Practice Address - Fax:831-244-9069
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ02734000122300000X
CT12639122300000X
NY318937208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist
No208600000XAllopathic & Osteopathic PhysiciansSurgery