Provider Demographics
NPI:1326071853
Name:SHERYL HABER KUO MD PC
Entity Type:Organization
Organization Name:SHERYL HABER KUO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:HABER
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-586-9566
Mailing Address - Street 1:2312 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1953
Mailing Address - Country:US
Mailing Address - Phone:609-586-9566
Mailing Address - Fax:609-586-9055
Practice Address - Street 1:2312 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE #201
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1953
Practice Address - Country:US
Practice Address - Phone:609-586-9566
Practice Address - Fax:609-586-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ63867207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ025841Medicare ID - Type Unspecified