Provider Demographics
NPI:1366821019
Name:HAIMOF, YAKOV (DPM)
Entity Type:Individual
Prefix:
First Name:YAKOV
Middle Name:
Last Name:HAIMOF
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 1:185 BRIDGE PLZ N
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5907
Mailing Address - Country:US
Mailing Address - Phone:201-363-9844
Mailing Address - Fax:201-363-9662
Practice Address - Street 1:185 BRIDGE PLZ N
Practice Address - Street 2:SUITE 4
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5907
Practice Address - Country:US
Practice Address - Phone:201-363-9844
Practice Address - Fax:201-363-9662
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00325300213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery