Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35060338 | OH |
N | 111NI0900X | Internist | 35060338 | OH |
Y | 207RC0000X | Internist - Cardiovascular Disease | 35060338 | OH |
N | 207RC0000X | Internist - Cardiovascular Disease | MD420867 | PA |
NPI | 1003807025 |
---|---|
Provider Name | Dr. Jeffrey C Halley |
First Address | Youngstown, OH 44512-7004 |
Second Address | Youngstown, OH 44512-7004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 10/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0161328 | (05) | OH |
01766785 | (05) | PA |
G07396 | (02) | OH |