MEDICARE: JESSE HALPERN

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	1223G0001X	General Practice Dentistry	062513	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	062513	OTHER	NY	NYS DENTAL LICENSE

General Provider Information

NPI Number	:	1881287563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE HALPERN

Provider Business Mailing Address
First Line	:	3B OLDE WILLOW WAY
Second Line	:
City	:	BRIARCLIFF MANOR
State	:	NY
Zip	:	10510-1465
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 CROMPOND RD
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4231
Country	:	US
Telephone Number	:	914-243-7777
Fax Number	:

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

Provider Enumeration Date	:	02/14/2021
Last Update Date	:	01/30/2023

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Directions to “ JESSE HALPERN ” Practice Location

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