Provider Demographics
NPI:1174758684
Name:VERA V. HALBFASS PODIATRY PC
Entity type:Organization
Organization Name:VERA V. HALBFASS PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALBFASS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-754-7084
Mailing Address - Street 1:20 BAYARD ST
Mailing Address - Street 2:APT. 4E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-1256
Mailing Address - Country:US
Mailing Address - Phone:917-754-7084
Mailing Address - Fax:718-388-4198
Practice Address - Street 1:20 BAYARD ST
Practice Address - Street 2:APT. 4E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-1256
Practice Address - Country:US
Practice Address - Phone:917-754-7084
Practice Address - Fax:718-388-4198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006020213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPJ2871Medicare PIN