Basic Information
| Provider Information | |||||||||
| NPI: | 1982794012 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HALLEGADO | ||||||||
| FirstName: | ARLENE | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 BRABHAM LN | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285465003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103413300 | ||||||||
| FaxNumber: | 9102512067 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 BRABHAM LN | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285465003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103413300 | ||||||||
| FaxNumber: | 9102512067 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 08/05/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2012-01744 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 411537 | 01 | NJ | CIGNA | OTHER | 5902147 | 01 | NJ | GHI | OTHER | 13714 | 01 | NJ | UHP | OTHER | 478425 | 01 | NJ | AETNA | OTHER | 6689701 | 05 | NJ | MEDICAID | OK9025 | 01 | NJ | HEALTHNET | OTHER | 0314423001 | 01 | NJ | AMERIHEALTH | OTHER | 1864386 | 01 | NJ | UNITED | OTHER | EP265 | 01 | NJ | OXFORD | OTHER | 223620928 | 01 | NJ | LOCAL 472 | OTHER | 1067718 | 01 | NJ | NJ HEALTH | OTHER | 01000059400 | 01 | NJ | AMERICHOICE | OTHER | 81448 | 01 | NJ | AMERIGROUP | OTHER | J2399 | 01 | NJ | HORIZON | OTHER |