Provider Demographics
NPI:1093868549
Name:HALPERN, DAVIN L (DC)
Entity Type:Individual
Prefix:
First Name:DAVIN
Middle Name:L
Last Name:HALPERN
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 1:842 FORT SALONGA RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2251
Mailing Address - Country:US
Mailing Address - Phone:631-757-3000
Mailing Address - Fax:631-757-9474
Practice Address - Street 1:842 FORT SALONGA RD.
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2251
Practice Address - Country:US
Practice Address - Phone:631-757-3000
Practice Address - Fax:631-757-9474
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT53136Medicare UPIN
NYX29461Medicare PIN