Provider Demographics
NPI:1447096490
Name:HALL, DAESHAWN JOSEPH
Entity type:Individual
Prefix:
First Name:DAESHAWN
Middle Name:JOSEPH
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4222 KETCHAM ST # B5B6
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2368
Mailing Address - Country:US
Mailing Address - Phone:518-364-5701
Mailing Address - Fax:
Practice Address - Street 1:4222 KETCHAM ST # B5B6
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2368
Practice Address - Country:US
Practice Address - Phone:518-364-5701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No1744R1102XOther Service ProvidersSpecialistResearch Study
No174H00000XOther Service ProvidersHealth Educator
No1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No253Z00000XAgenciesIn Home Supportive Care
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No332S00000XSuppliersHearing Aid Equipment