Provider Demographics
NPI:1487982898
Name:HALPIN, TAE SUN
Entity type:Individual
Prefix:
First Name:TAE
Middle Name:SUN
Last Name:HALPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4079
Mailing Address - Country:US
Mailing Address - Phone:973-406-7088
Mailing Address - Fax:973-767-1290
Practice Address - Street 1:1510 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-4079
Practice Address - Country:US
Practice Address - Phone:973-406-7088
Practice Address - Fax:973-767-1290
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26BT00191300173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist