Individual
DR. CHAD BENJAMIN HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3074 36TH ST, ASTORIA, NY 11103-4705
(718) 728-0224
(718) 728-1626
Mailing address
3720 INDEPENDENCE AVE, APT #1F, BRONX, NY 10463-1429
(917) 743-3462
(718) 728-0626
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
223411
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2577791
—
NY
Enumeration date
11/04/2005
Last updated
01/09/2008
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