Healthcare Provider Details

I. General information

NPI: 1467706119
Provider Name (Legal Business Name): WILLIAM HALPERIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2012
Last Update Date: 11/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 S ORANGE AVE MSB F506
NEWARK NJ
07103-2757
US

IV. Provider business mailing address

PO BOX 639
BARNEGAT LIGHT NJ
08006-0639
US

V. Phone/Fax

Practice location:
  • Phone: 973-972-4422
  • Fax:
Mailing address:
  • Phone: 513-254-3833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number25MA03264400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: