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General NPI Number Information
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NPI Number | 1861117905
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Entity Type | Organization
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Legal Business Name | DR DELVERLON HALL PARK AVENUE PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 10 PARK AVE STE 2D
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City | NEW YORK
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State | NY
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Zip | 10016-4338
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Country | US
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Telephone | 917-576-1544
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Fax |
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Provider Business Mailing Address
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Address Line | 8 PENZIAS PL
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City | HIGHLAND PARK
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State | NJ
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Zip | 08904-1677
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Country | US
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Telephone | 917-576-1544
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | DR. DELVERLON HALL
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Credential | LCSW
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Telephone | 917-576-1544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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