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General NPI Number Information
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NPI Number | 1851045462
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Entity Type | Organization
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Legal Business Name | RICHARD HALLENBECK PHYSICIAN PLLC
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Dates
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Enumeration Date | 02/11/2022
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 8708 JUSTICE AVE STE CM
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City | ELMHURST
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State | NY
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Zip | 11373-8715
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Country | US
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Telephone | 718-507-2000
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Fax | 718-507-2358
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Provider Business Mailing Address
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Address Line | 8708 JUSTICE AVE STE CM
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City | ELMHURST
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State | NY
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Zip | 11373-8715
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Country | US
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Telephone | 718-507-2000
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Fax | 718-507-2358
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Authorized Official
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Title or Position | PHYSICIAN
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Name | RICHARD HALLENBECK
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Credential | MD
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Telephone | 914-406-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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