Provider Demographics
NPI:1750571162
Name:HALPERN, SAMUEL RYAN (O D)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:RYAN
Last Name:HALPERN
Suffix:
Gender:
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BANNING ST
Mailing Address - Street 2:STE 130
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3486
Mailing Address - Country:US
Mailing Address - Phone:302-450-3025
Mailing Address - Fax:302-990-4441
Practice Address - Street 1:200 BANNING ST STE 130
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3486
Practice Address - Country:US
Practice Address - Phone:302-678-1700
Practice Address - Fax:302-678-2330
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI30001321152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEID2289OtherGROUP MEDICARE PTAN - HALPERN MEDICAL SERVICES. LLC
DEG00016OtherMEDICARE GROUP PIN
DE1346430360OtherGROUP NPI - EYE SPECIALISTS OF DELAWARE
DEG01047OtherMEDICARE GROUP PTAN - EYE SPECIALISTS OF DELAWARE
DE022756H16OtherMEDICARE INDIVIDUAL PTAN
DEI3-0001321OtherSTATE LICENSE
1245251313OtherGROUP NPI