Provider Demographics
NPI:1194045930
Name:AUDREY HALPERN MD PC
Entity Type:Organization
Organization Name:AUDREY HALPERN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALPERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-271-9151
Mailing Address - Street 1:108 W 39TH ST RM 405
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3649
Mailing Address - Country:US
Mailing Address - Phone:646-559-4659
Mailing Address - Fax:
Practice Address - Street 1:108 W 39TH ST RM 405
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3649
Practice Address - Country:US
Practice Address - Phone:646-559-4659
Practice Address - Fax:917-633-4365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY228806OtherLICENSE