Healthcare Provider Details

I. General information

NPI: 1689691594
Provider Name (Legal Business Name): NICHOLAS R HALPER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MAPLE AVE STE 102
ROCKVILLE CENTRE NY
11570-4267
US

IV. Provider business mailing address

55 MAPLE AVE STE 102
ROCKVILLE CENTRE NY
11570-4267
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-2221
  • Fax: 516-764-8747
Mailing address:
  • Phone: 516-536-2221
  • Fax: 516-764-8747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MUNEERA PAWA
Title or Position: BILLING
Credential:
Phone: 516-536-2221