Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 158611-1 | NY |
Y | 207W00000X | Ophthalmologist | 25MA04964000 | NJ |
NPI | 1023019171 |
---|---|
Provider Name | Dr. James E. Haberman |
First Address | Union, NJ 07083-5745 |
Second Address | Union, NJ 07083-5745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 07/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0465909 | (05) | NJ |
A64083 | (02) | NJ |