Individual
MR. JONATHAN MAGHUYOP HALASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
177 FORT WASHINGTON AVE, MHB 7GN-435, NEW YORK, NY 10032-3733
(212) 305-2633
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
(646) 608-1880
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
25MP00625600
NJ
363AM0700X
Medical Physician Assistant
011598
NY
363AS0400X
Surgical Physician Assistant
Primary
011598
NY
Other
Enumeration date
08/07/2007
Last updated
11/06/2025
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