Provider Demographics
NPI:1508407495
Name:HABA, HALYNA
Entity Type:Individual
Prefix:MRS
First Name:HALYNA
Middle Name:
Last Name:HABA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 AUGUSTA CT
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-5236
Mailing Address - Country:US
Mailing Address - Phone:516-455-4808
Mailing Address - Fax:
Practice Address - Street 1:4 AUGUSTA CT
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-5236
Practice Address - Country:US
Practice Address - Phone:516-455-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00960700363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner