Provider Demographics
NPI:1285844175
Name:HADDAD, JOANNE TERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:TERESA
Last Name:HADDAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CLARISSA DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-1634
Mailing Address - Country:US
Mailing Address - Phone:732-706-0495
Mailing Address - Fax:732-706-5115
Practice Address - Street 1:8 CLARISSA DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-1634
Practice Address - Country:US
Practice Address - Phone:732-706-0495
Practice Address - Fax:732-706-5115
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA048798207PH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0487503Medicaid
NJ44751OtherCDS
NJ44751OtherCDS