Provider Demographics
NPI:1407621634
Name:HALIOS, JOAN MARY
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:MARY
Last Name:HALIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 CORPORATE CIR STE 214
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5176
Mailing Address - Country:US
Mailing Address - Phone:518-456-4466
Mailing Address - Fax:518-456-4536
Practice Address - Street 1:127 BLOOMINGROVE DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-8404
Practice Address - Country:US
Practice Address - Phone:518-283-4921
Practice Address - Fax:518-687-0375
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
684288246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty