Provider Demographics
NPI:1619029527
Name:HALPERN, ANALISA VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:ANALISA
Middle Name:VINCENT
Last Name:HALPERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 KING OF PRUSSIA RD STE 306
Mailing Address - Street 2:
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-4557
Mailing Address - Country:US
Mailing Address - Phone:610-902-2400
Mailing Address - Fax:610-902-2404
Practice Address - Street 1:145 KING OF PRUSSIA RD STE 306
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087-4557
Practice Address - Country:US
Practice Address - Phone:610-902-2400
Practice Address - Fax:610-902-2404
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD438692207N00000X
NJ25MA07819700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD438692OtherLICENSE
NJ25MA07819700OtherLICENSE