Provider Demographics
NPI:1831286921
Name:HABERMANN, JOANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANN
Middle Name:
Last Name:HABERMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:55 E 93RD ST
Mailing Address - Street 2:APT. 5-D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1302
Mailing Address - Country:US
Mailing Address - Phone:212-348-7191
Mailing Address - Fax:212-348-7191
Practice Address - Street 1:150 BERGEN ST
Practice Address - Street 2:UH E139A
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2496
Practice Address - Country:US
Practice Address - Phone:973-972-5712
Practice Address - Fax:973-972-5724
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07050600207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH53611Medicare UPIN