Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 25MA06224800 | NJ |
NPI | 1164487724 |
---|---|
Provider Name | Paul B Haser |
First Address | Brooklyn, NY 11212 |
Second Address | Brooklyn, NY 11212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 20/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8033501 | (05) | NJ |
G52041 | (02) | NJ |
P00461697 | RR MCR PTAN (01) | NJ |