Provider Demographics
NPI:1710602883
Name:TAYLOR, HALSEY SHAE
Entity Type:Individual
Prefix:
First Name:HALSEY
Middle Name:SHAE
Last Name:TAYLOR
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 1:555 10TH AVE APT 42G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-0668
Mailing Address - Country:US
Mailing Address - Phone:941-525-4986
Mailing Address - Fax:
Practice Address - Street 1:225 E 35TH ST APT 10H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4208
Practice Address - Country:US
Practice Address - Phone:917-699-3642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT460-337-96-837-0Medicaid