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General NPI Number Information
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NPI Number | 1437340122
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Entity Type | Individual
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Provider Name | JONATHAN MAGHUYOP HALASAN RPA-C
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Gender | Male
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 177 FORT WASHINGTON AVE MHB 7GN-435
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City | NEW YORK
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State | NY
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Zip | 10032-3733
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Country | US
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Telephone | 212-305-2633
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone | 646-608-1880
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 011598
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MP00625600
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 011598
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License Number State | NY
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