Provider Demographics
NPI:1376850412
Name:HALLAHAN, TERRENCE W (PH D)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:W
Last Name:HALLAHAN
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:80 RULAND RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4211
Mailing Address - Country:US
Mailing Address - Phone:631-425-0800
Mailing Address - Fax:631-425-0811
Practice Address - Street 1:80 RULAND RD
Practice Address - Street 2:SUITE 1
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4211
Practice Address - Country:US
Practice Address - Phone:631-425-0800
Practice Address - Fax:631-425-0811
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYHALLT1246QL0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QL0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory Management