Provider Demographics
NPI:1639160377
Name:HALPERN, FAY (DPM)
Entity Type:Individual
Prefix:DR
First Name:FAY
Middle Name:
Last Name:HALPERN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20943 32ND AVE.
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-1062
Mailing Address - Country:US
Mailing Address - Phone:718-291-7900
Mailing Address - Fax:718-291-9603
Practice Address - Street 1:8339 DANIELS ST
Practice Address - Street 2:
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-1208
Practice Address - Country:US
Practice Address - Phone:718-291-7900
Practice Address - Fax:718-291-9603
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004235213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01048264Medicaid
NYP49881Medicare PIN
NY14389Medicare PIN
NY01048264Medicaid