Individual
DR. ERIC HYIAM THALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 N VILLAGE AVE, SUITE 300, ROCKVILLE CENTRE, NY 11570-2341
(516) 766-2929
(516) 766-7728
Mailing address
200 N VILLAGE AVE, SUITE 300, ROCKVILLE CENTRE, NY 11570-2341
(516) 766-2929
(516) 766-7728
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
191069
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000068631
GHI HMO
—
05
—
01836933
—
NY
01
—
1099460
GHI
—
01
—
136196-A32
HEALTH FIRST
—
01
—
191069
HIP
—
01
—
200649
UNIFORMED SERVICES
—
01
—
2214116
AETNA
—
01
—
2C7429
CARE CORE
—
01
—
340017949
RAILROAD MEDICARE
NY
01
—
74266
VYTRA
—
01
—
ET055T9710
BLUE CROSS BLUE SHIELD
NY
01
—
P589155
OXFORD
—
Enumeration date
11/03/2005
Last updated
02/21/2008
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