Provider Demographics
NPI:1922051556
Name:HAUPTMAN, IRA ALAN (DPM)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:ALAN
Last Name:HAUPTMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 COLUMBIA TPKE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1244
Mailing Address - Country:US
Mailing Address - Phone:973-966-1200
Mailing Address - Fax:973-966-0238
Practice Address - Street 1:256 COLUMBIA TPKE
Practice Address - Street 2:SUITE 203
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1244
Practice Address - Country:US
Practice Address - Phone:973-966-1200
Practice Address - Fax:973-966-0238
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD001125213EP1101X, 213ES0000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0626104Medicaid
NJ0626104Medicaid