Provider Demographics
NPI:1033108782
Name:HAFFTY, BRUCE G (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:G
Last Name:HAFFTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4947
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:195 LITTLE ALBANY ST
Practice Address - Street 2:THE CANCER INSTITUTE OF NEW JERSEY ROOM 2006
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1914
Practice Address - Country:US
Practice Address - Phone:732-235-5203
Practice Address - Fax:732-235-7493
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0276742085R0001X
NJ25MA078861002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0066630Medicaid
NJ001276741Medicaid
E24303Medicare UPIN
NJ300000899Medicare ID - Type Unspecified
NJ091235ZANLMedicare PIN