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General NPI Number Information
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NPI Number | 1588124028
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Entity Type | Individual
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Provider Name | LEANGELO N HALL M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 1140 WHITE HORSE ROAD SUITE 1
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City | VOORHEES
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State | NJ
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Zip | 08043-2106
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Country | US
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Telephone | 856-784-3366
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Fax | 856-784-4388
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Provider Business Mailing Address
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Address Line | 1140 WHITE HORSE ROAD SUITE 1
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City | VOORHEES
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State | NJ
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Zip | 08043-2106
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Country | US
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Telephone | 856-784-3366
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Fax | 856-784-4388
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25MA12222700
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License Number State | NJ
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