Basic Information
| Provider Information | |||||||||
| NPI: | 1649241100 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HALPERN | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | NOAH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3838 NEPTUNE AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112241328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183720263 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3632 NOSTRAND AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112295303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183324409 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2006 | ||||||||
| LastUpdateDate: | 04/02/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 165127 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 2330747 | 01 | NY | UNTIED HEALTHCARE | OTHER | 0315238 | 01 | NY | CIGNA | OTHER | 010186-01 | 01 | NY | AMERICHOICE | OTHER | 01344421 | 05 | NY | MEDICAID | 4100368 | 01 | NY | GHI | OTHER | 2446E1 | 01 | NY | EMPIRE BC/BS | OTHER |