Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 10267883-9924 | UT |
N | 204E00000X | Oral & Maxillofacial Surgeon | 7445 | TN |
NPI | 1023009669 |
---|---|
Provider Name | Dr. Leslie Robin Halpern |
First Address | Nashville, TN 37208-9142 |
Second Address | Nashville, TN 37208-9142 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 02/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
019997 | TUFTS HEALTH PLAN (01) | MA |
G43770 | (02) | |
V05611 | BCBS MA (01) | MA |