Provider Demographics
NPI:1063720076
Name:HALLENBECK, WILLIAM SETH III (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SETH
Last Name:HALLENBECK
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:248 RACE RD
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:NY
Mailing Address - Zip Code:13778-4157
Mailing Address - Country:US
Mailing Address - Phone:607-656-9700
Mailing Address - Fax:607-656-9700
Practice Address - Street 1:248 RACE RD
Practice Address - Street 2:
Practice Address - City:GREENE
Practice Address - State:NY
Practice Address - Zip Code:13778-4157
Practice Address - Country:US
Practice Address - Phone:607-656-9700
Practice Address - Fax:607-656-9700
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087920207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00627078Medicaid
NY00627078Medicaid