Healthcare Provider Details

I. General information

NPI: 1134108673
Provider Name (Legal Business Name): ALAN J HALPERIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MIDLAND AVE
PORT CHESTER NY
10573-4943
US

IV. Provider business mailing address

7111 FAIRWAY DR SUITE 400
PALM BEACH GARDENS FL
33418-4204
US

V. Phone/Fax

Practice location:
  • Phone: 800-942-3376
  • Fax: 914-934-9819
Mailing address:
  • Phone: 561-712-6265
  • Fax: 561-712-7349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number109386-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number109386-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: