Provider Demographics
NPI:1730175308
Name:HABER, EMANUEL M (DPM)
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:M
Last Name:HABER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W CENTURY RD
Mailing Address - Street 2:FOOT & ANKLE CTR OF NJ
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1433
Mailing Address - Country:US
Mailing Address - Phone:201-599-5911
Mailing Address - Fax:201-599-5960
Practice Address - Street 1:30 W CENTURY RD
Practice Address - Street 2:FOOT & ANKLE CTR OF NJ
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1433
Practice Address - Country:US
Practice Address - Phone:201-599-5911
Practice Address - Fax:201-599-5960
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001556213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T84896Medicare UPIN
NJ133818Medicare PIN