Provider Demographics
NPI:1750675195
Name:HALPERN, JESSICA NICOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:NICOLE
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 1:608 SHERWOOD PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2512
Mailing Address - Country:US
Mailing Address - Phone:908-379-8258
Mailing Address - Fax:888-517-4388
Practice Address - Street 1:608 SHERWOOD PKWY STE 106
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2512
Practice Address - Country:US
Practice Address - Phone:908-379-8258
Practice Address - Fax:888-517-4388
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2774452084P0800X
390200000X
NJ25MA098645002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program