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1538221015

NPI Code Detail

MEDICARE: OWEN J HALLORAN MD

MEDICARE: OWEN J HALLORAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	MT188744	PA
2	207L00000X	Anesthesiology Physician	D68596	MD
3	207L00000X	Anesthesiology Physician	270594	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538221015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OWEN J HALLORAN MD

Provider Business Mailing Address
First Line	:	1450 WESTERN AVE STE 102
Second Line	:	ANESTHESIA GROUP OF ALBANY, PC
City	:	ALBANY
State	:	NY
Zip	:	12203-3539
Country	:	US
Telephone Number	:	518-463-0050
Fax Number	:	518-207-2973

Provider Business Practice Location Address
First Line	:	2215 BURDETT AVE
Second Line	:
City	:	TROY
State	:	NY
Zip	:	12180-2475
Country	:	US
Telephone Number	:	518-525-8600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	03/16/2023

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Directions to “ OWEN J HALLORAN MD” Practice Location

Language	Start Address	Practice Location

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