Provider Demographics
NPI:1285923573
Name:HALL, JEFFREY (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 EISENHOWER PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1054
Mailing Address - Country:US
Mailing Address - Phone:973-795-1260
Mailing Address - Fax:973-795-1259
Practice Address - Street 1:101 EISENHOWER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068
Practice Address - Country:US
Practice Address - Phone:973-795-1260
Practice Address - Fax:973-795-1259
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI637262084P0800X
NJ25MA103686002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry