Individual
GEOFFREY STUART HALBERSTADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 CONTINENTAL AVENUE, SUITE 1 G, FOREST HILLS, NY 11375-5266
(718) 261-1400
(718) 261-1401
Mailing address
86 VOORHIS AVE, ROCKVILLE, NY 11570-2746
(516) 729-7736
(516) 678-0289
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
032513
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01203763
—
NY
05
—
1083719223
—
NY
Enumeration date
09/13/2006
Last updated
04/23/2019
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