Provider Demographics
NPI:1023534518
Name:HALL, NELSON MERRITT (DC)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:MERRITT
Last Name:HALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 BARTOW AVE, STE #227
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475
Mailing Address - Country:US
Mailing Address - Phone:718-379-1000
Mailing Address - Fax:718-320-9380
Practice Address - Street 1:2100 BARTOW AVE, STE #227
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475
Practice Address - Country:US
Practice Address - Phone:718-379-1000
Practice Address - Fax:718-320-9380
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00746300111N00000X
NYX012986-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor