MEDICARE: DR. JOSEPH HALBACH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	140563	NY

General Provider Information

NPI Number	:	1164498788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH HALBACH MD

Provider Business Mailing Address
First Line	:	7901 BROADWAY
Second Line	:	ELMHURST HOSPITAL CENTER E6-7
City	:	ELMHURST
State	:	NY
Zip	:	11373-1329
Country	:	US
Telephone Number	:	718-334-5224
Fax Number	:

Provider Business Practice Location Address
First Line	:	7901 BROADWAY
Second Line	:	ELMHURST HOSPITAL CENTER E6-7
City	:	ELMHURST
State	:	NY
Zip	:	11373-1329
Country	:	US
Telephone Number	:	718-334-5224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	11/07/2008

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