Provider Demographics
NPI:1548450752
Name:HALL, MICHELE RENEE (NP)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:RENEE
Last Name:HALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:222 E 70TH ST
Mailing Address - Street 2:1ST FL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5405
Mailing Address - Country:US
Mailing Address - Phone:212-434-5104
Mailing Address - Fax:212-628-5687
Practice Address - Street 1:222 E 70TH ST
Practice Address - Street 2:1ST FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5405
Practice Address - Country:US
Practice Address - Phone:212-434-5104
Practice Address - Fax:212-628-5687
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF303692-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health