Provider Demographics
NPI:1659423937
Name:HABER, GREGORY B (MD)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:B
Last Name:HABER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EAST 77TH STREET
Mailing Address - Street 2:
Mailing Address - City:NYC
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-434-6279
Mailing Address - Fax:212-434-2446
Practice Address - Street 1:530 1ST AVE # HCC4G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:646-501-2465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP36094207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2499048OtherGHI PPO
P3462297OtherOXFORD
2458969OtherUNITED HEALTH CARE
3680094OtherAETNA HMO
4V3021OtherBCBS
7817592OtherAETNA PPO
000000087161OtherGHI HMO
180865POtherHIP
NY4V3171Medicare PIN
000000087161OtherGHI HMO