Provider Demographics
NPI:1124101571
Name:HALL, HENRY NELSON (DC)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:NELSON
Last Name:HALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1981 MARCUS AVE
Mailing Address - Street 2:STE C114
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1032
Mailing Address - Country:US
Mailing Address - Phone:516-987-4200
Mailing Address - Fax:800-297-0976
Practice Address - Street 1:2100 BARTOW AVE
Practice Address - Street 2:STE 227
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4614
Practice Address - Country:US
Practice Address - Phone:718-320-9000
Practice Address - Fax:718-320-9380
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYX0043541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
C0043549OtherWCB
NYA400070173Medicare PIN
NYA100069605Medicare PIN