Provider Demographics
NPI:1952807893
Name:PEARL, HALLIE GREEN (MD)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:GREEN
Last Name:PEARL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HALLIE
Other - Middle Name:ERIN
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:77 W MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1663
Mailing Address - Country:US
Mailing Address - Phone:508-435-7100
Mailing Address - Fax:508-435-7110
Practice Address - Street 1:77 W MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1663
Practice Address - Country:US
Practice Address - Phone:508-435-7100
Practice Address - Fax:508-435-7110
Is Sole Proprietor?:No
Enumeration Date:2018-03-31
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA287038208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110135532AMedicaid