Basic Information
| Provider Information | |||||||||
| NPI: | 1700991239 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2601 OCEAN PARKWAY | ||||||||
| Address2: | CONEY ISLAND HOSPITAL | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186163445 | ||||||||
| FaxNumber: | 7186164436 | ||||||||
| Practice Location | |||||||||
| Address1: | 2601 OCEAN PARKWAY | ||||||||
| Address2: | CONEY ISLAND HOSPITAL | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186163445 | ||||||||
| FaxNumber: | 7186164436 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2006 | ||||||||
| LastUpdateDate: | 03/25/2015 | ||||||||
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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 | 2086S0102X | 042879 | CT | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 208G00000X | 042879 | CT | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.