Provider Demographics
NPI:1023039211
Name:HABEK, PAUL F (CRNA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:F
Last Name:HABEK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 ROUTE 25A STE 225
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8802
Mailing Address - Country:US
Mailing Address - Phone:631-744-0396
Mailing Address - Fax:
Practice Address - Street 1:333 ROUTE 25A STE 225
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8802
Practice Address - Country:US
Practice Address - Phone:631-744-0396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY499658-1163WP0000X
NY499658367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WP0000XNursing Service ProvidersRegistered NursePain Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR3C531Medicare ID - Type UnspecifiedMEDICARE