Provider Demographics
NPI:1053578534
Name:CAMACHO-HALILI, MARIE M (MD)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:M
Last Name:CAMACHO-HALILI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:245 US HIGHWAY 22
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2560
Practice Address - Country:US
Practice Address - Phone:908-722-1022
Practice Address - Fax:908-722-2040
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08908400207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ225956NEWMedicare PIN