Provider Demographics
NPI:1851045462
Name:RICHARD HALLENBECK PHYSICIAN PLLC
Entity Type:Organization
Organization Name:RICHARD HALLENBECK PHYSICIAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLENBECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-406-1112
Mailing Address - Street 1:8708 JUSTICE AVE STE CM
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-8715
Mailing Address - Country:US
Mailing Address - Phone:718-507-2000
Mailing Address - Fax:718-507-2358
Practice Address - Street 1:8708 JUSTICE AVE STE CM
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-8715
Practice Address - Country:US
Practice Address - Phone:718-507-2000
Practice Address - Fax:718-507-2358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty