Provider Demographics
NPI:1467992784
Name:HALL, HARRISON AJ (NBC-HWC, ATC, CSCS)
Entity type:Individual
Prefix:
First Name:HARRISON
Middle Name:AJ
Last Name:HALL
Suffix:
Gender:M
Credentials:NBC-HWC, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 DUKES ST APT 1
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-3308
Mailing Address - Country:US
Mailing Address - Phone:508-641-0503
Mailing Address - Fax:
Practice Address - Street 1:179 DUKES ST APT 1
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3308
Practice Address - Country:US
Practice Address - Phone:508-641-0503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty