Provider Demographics
NPI:1740608413
Name:HALPERIN, MARC PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:PHILIP
Last Name:HALPERIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:122 E 42ND ST FL 32
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10168-3299
Mailing Address - Country:US
Mailing Address - Phone:917-540-0230
Mailing Address - Fax:917-900-1602
Practice Address - Street 1:122 E 42ND ST FL 32
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10168-3299
Practice Address - Country:US
Practice Address - Phone:917-540-0230
Practice Address - Fax:917-900-1602
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2929952084P0804X, 2084P0800X
CT622812084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICLP03359Medicaid