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NPI Code Detail

MEDICARE: MARK HALL PMHNP, NPP

MEDICARE: MARK HALL PMHNP, NPP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner401869NY
2363LA2200XAdult Health Nurse Practitioner307355NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598193989
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK HALL PMHNP, NPP
Provider Business Mailing Address
First Line : 1115 BROADWAY STE 1108
Second Line :
City : NEW YORK
State : NY
Zip : 10010-3450
Country : US
Telephone Number : 646-500-8627
Fax Number : 646-863-1427
Provider Business Practice Location Address
First Line : 16 MADISON SQ W STE 1108
Second Line :
City : NEW YORK
State : NY
Zip : 10010-1629
Country : US
Telephone Number : 646-500-8627
Fax Number : 646-863-1427
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2013
Last Update Date : 09/19/2025

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