Provider Demographics
NPI:1467482398
Name:HASPEL, MARC
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:HASPEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3631
Mailing Address - Country:US
Mailing Address - Phone:973-777-4650
Mailing Address - Fax:973-777-8298
Practice Address - Street 1:1100 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3631
Practice Address - Country:US
Practice Address - Phone:973-777-4650
Practice Address - Fax:973-777-8298
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD1914213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5110700Medicaid
NJ708332Medicare ID - Type Unspecified
NJU18038Medicare UPIN
NJ5110700Medicaid