Healthcare Provider Details

I. General information

NPI: 1689981136
Provider Name (Legal Business Name): REBECCA J. HALPERN MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2010
Last Update Date: 06/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 TOWER DR STE 400
MIDDLETOWN NY
10941-2056
US

IV. Provider business mailing address

57 CHURCH ST
NEW PALTZ NY
12561-1508
US

V. Phone/Fax

Practice location:
  • Phone: 845-692-4391
  • Fax:
Mailing address:
  • Phone: 845-235-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number020440
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: