Provider Demographics
NPI:1295760270
Name:HALPERN, NEAL B (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:B
Last Name:HALPERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-5356
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:PMG HIGH RESORT 4005
Practice Address - Street 2:4005 HIGH RESORT BLVD
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124
Practice Address - Country:US
Practice Address - Phone:505-462-6000
Practice Address - Fax:505-462-8470
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM76-47207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2881Medicaid
NM2881Medicaid
34C727403Medicare PIN