Healthcare Provider Details

I. General information

NPI: 1730008897
Provider Name (Legal Business Name): ESTEGUL ESHIMOVA-HALL M.S. ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 VAN NAME AVE
STATEN ISLAND NY
10303-2545
US

IV. Provider business mailing address

93 VAN NAME AVE
STATEN ISLAND NY
10303-2545
US

V. Phone/Fax

Practice location:
  • Phone: 347-453-7182
  • Fax:
Mailing address:
  • Phone: 347-453-7182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number3144166
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: