Provider Demographics
NPI:1982652731
Name:HAFLIN, MARY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:HAFLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 NEW JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260-2734
Mailing Address - Country:US
Mailing Address - Phone:609-522-3131
Mailing Address - Fax:
Practice Address - Street 1:1200 NEW JERSEY AVE
Practice Address - Street 2:
Practice Address - City:NORTH WILDWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08260-2734
Practice Address - Country:US
Practice Address - Phone:609-522-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA025867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ139714SBVOtherMEDICARE ID TYPE
NJ1506404Medicaid
NJ139714SBVOtherMEDICARE ID TYPE
NJ139714A1TMedicare ID - Type Unspecified