Healthcare Provider Details

I. General information

NPI: 1922926351
Provider Name (Legal Business Name): HALO MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

796 MILLBROOK RD
RIVER EDGE NJ
07661-1514
US

IV. Provider business mailing address

796 MILLBROOK RD
RIVER EDGE NJ
07661-1514
US

V. Phone/Fax

Practice location:
  • Phone: 646-382-8753
  • Fax:
Mailing address:
  • Phone: 646-382-8753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY DEYGOO
Title or Position: OWNER
Credential: MD
Phone: 646-382-8753