Provider Demographics
NPI:1497706881
Name:HABER, JENNIFER B (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:B
Last Name:HABER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1278 HOOPER AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3324
Mailing Address - Country:US
Mailing Address - Phone:732-505-0533
Mailing Address - Fax:732-505-6572
Practice Address - Street 1:670 ROUTE 1 NORTH
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830
Practice Address - Country:US
Practice Address - Phone:732-636-1400
Practice Address - Fax:732-636-1401
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU51488Medicare UPIN
NJ533121Medicare ID - Type UnspecifiedMEDICARE