Provider Demographics
NPI:1356313878
Name:HALL, JASON O (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:O
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:225 JACKSON STREET
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3060
Mailing Address - Country:US
Mailing Address - Phone:908-526-8668
Mailing Address - Fax:908-231-6781
Practice Address - Street 1:225 JACKSON STREET
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3060
Practice Address - Country:US
Practice Address - Phone:908-526-8668
Practice Address - Fax:908-231-6781
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2012-08-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA51488207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1796801Medicaid
NJ581591B86Medicare PIN
NJ1796801Medicaid