Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1003437310 Individual Practitioner Male Practitioner

Dr. Jack Daniel Halligan , MD

Pediatrics • Bronx, NY

Professional Overview & Biography Verified Profile Summary

Dr. Jack Halligan, MD is a registered healthcare professional specializing in Pediatrics in Bronx, NY. Practice services are available at 111 E 210TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

111 E 210th St

Bronx, NY 104672401

Telephone 7189204321
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Bronx, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.7 Yrs
State Avg: 24.1 Yrs
Regional Practice Density
590 Specialists

Practicing in Bronx, NY (6127 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-04-08
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License PA MT220997

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

State License NY 325482

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Jiae Lee , MD

Psychiatry & Neurology - Neurology

NPI 1003262916

Doctor of Medicine (M.D.)

NPI 1003340456

Doctor of Medicine (M.D.)

Telisha Mclean

Nurse Practitioner - Family

NPI 1003359910
Shivaditya Choudhury

Anesthesiology

NPI 1003377490
Johanna Tan

Student in an Organized Health Care Education/Training Program

NPI 1003436999
Arian Ghanouni

Student in an Organized Health Care Education/Training Program

NPI 1003497884

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location April 08, 2025

Registered at 111 E 210TH ST, BRONX, NY 104672401 (Tel: 7189204321)

📍
Updated Business Mailing Address April 08, 2025

Registered at 111 E 210TH ST, BRONX, NY 104672401 (Tel: 7189204321)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 08, 2025

Student in an Organized Health Care Education/Training Program (License #325482 in NY)

📍
Updated Practice Location May 11, 2023

Registered at 818 ELLICOTT ST, BUFFALO, NY 142031021 (Tel: 7163230220)

📍
Updated Business Mailing Address May 11, 2023

Registered at 818 ELLICOTT ST, BUFFALO, NY 142031021

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 05, 2020

Pediatrics (License #MT220997 in PA)

NPI Profile Active April 28, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location April 28, 2020

Registered at 160 E ERIE AVE, PHILADELPHIA, PA 191341011 (Tel: 2154273768)

📍
Updated Business Mailing Address April 28, 2020

Registered at 160 E ERIE AVE, PHILADELPHIA, PA 191341011

👤
Provider Name / Credentials Updated April 28, 2020

Recorded as JACK HALLIGAN, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 28, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 28, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003437310
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 28, 2020
Last Update: April 08, 2025
Sole Proprietor: Yes

Mailing Address

111 E 210th St

Bronx, NY 104672401

Phone: 7189204321

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.