Provider Demographics
NPI:1023069457
Name:HABER, JOHN JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:HABER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 240
Mailing Address - Street 2:
Mailing Address - City:TRESCKOW
Mailing Address - State:PA
Mailing Address - Zip Code:18254-0240
Mailing Address - Country:US
Mailing Address - Phone:570-459-2070
Mailing Address - Fax:570-459-2072
Practice Address - Street 1:52 EAST MARKET STREET
Practice Address - Street 2:
Practice Address - City:TRESCKOW
Practice Address - State:PA
Practice Address - Zip Code:18254-0240
Practice Address - Country:US
Practice Address - Phone:570-459-2070
Practice Address - Fax:570-459-2072
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009036L207Q00000X
DEC2-0013440207P00000X
NY321689207P00000X
PAOS-009036-L207P00000X
FLOS17082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA892006Medicare ID - Type Unspecified
PAG34942Medicare UPIN