MEDICARE: DR. LAWRENCE ALOYSIUS HALL

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	103T00000X	Psychologist	35S100093900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35S100093900	OTHER	NJ	PSYCHOLOGY LIC. NO.

General Provider Information

NPI Number	:	1770620965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE ALOYSIUS HALL

Provider Business Mailing Address
First Line	:	PO BOX 7043
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-7043
Country	:	US
Telephone Number	:	973-325-8118
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 MULLARKEY DR
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2270
Country	:	US
Telephone Number	:	973-325-8118
Fax Number	:

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/13/2023

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