Provider Demographics
NPI:1366638421
Name:JOHN HALPERN DO PA
Entity Type:Organization
Organization Name:JOHN HALPERN DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESISDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALPERN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-553-1065
Mailing Address - Street 1:7797 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-6110
Mailing Address - Country:US
Mailing Address - Phone:954-722-6050
Mailing Address - Fax:
Practice Address - Street 1:7515 BANYAN WAY
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2618
Practice Address - Country:US
Practice Address - Phone:954-553-1065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6052208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80485BMedicare PIN