Provider Demographics
NPI:1639262538
Name:HALPERT, RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:HALPERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 TERRY RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-5102
Mailing Address - Country:US
Mailing Address - Phone:631-862-4011
Mailing Address - Fax:631-862-4017
Practice Address - Street 1:148 TERRY RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-5102
Practice Address - Country:US
Practice Address - Phone:631-862-4011
Practice Address - Fax:631-862-4017
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167013207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113276400OtherEMPIRE
NY05F613OtherBLUE CROSS BLUE SHIELD
NY113276400Other1199
NY409365OtherCIGNA
NYCP062OtherOXFORD
NY167013OtherHIP
NY0C5870OtherPHS
NY113276400OtherHORIZON
NY01566669Medicaid
NY2592OtherVYTRA
NY4093645OtherAETNA
NYAH00567OtherMDNY