Provider Demographics
NPI:1205885100
Name:HALBFASS, VERA VALESKA (DPM)
Entity type:Individual
Prefix:DR
First Name:VERA
Middle Name:VALESKA
Last Name:HALBFASS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 LEONARD ST
Mailing Address - Street 2:APT. 1E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-3943
Mailing Address - Country:US
Mailing Address - Phone:917-754-7084
Mailing Address - Fax:718-388-4198
Practice Address - Street 1:415 LEONARD ST
Practice Address - Street 2:APT 1E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-3943
Practice Address - Country:US
Practice Address - Phone:212-682-5290
Practice Address - Fax:212-599-3059
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006020213ES0131X
CT925213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPJ2871Medicare ID - Type Unspecified
NYU99430Medicare UPIN