Provider Demographics
NPI:1164487724
Name:HASER, PAUL B (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:B
Last Name:HASER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE BROOKDALE PLAZA
Mailing Address - Street 2:DIVISION OF VASCULAR SURGERY (CHC 214)
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212
Mailing Address - Country:US
Mailing Address - Phone:718-240-5751
Mailing Address - Fax:718-240-6631
Practice Address - Street 1:ONE BROOKDALE PLAZA
Practice Address - Street 2:DIVISION OF VASCULAR SURGERY (CHC 214)
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-5751
Practice Address - Fax:718-240-6631
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA062248002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8033501Medicaid
NJP00461697OtherRR MCR PTAN
NJ8033501Medicaid
NJP00461697OtherRR MCR PTAN
NJ031293Medicare ID - Type Unspecified