Provider Demographics
NPI:1912901695
Name:HABERMAN, FREDRIC (DO,)
Entity Type:Individual
Prefix:DR
First Name:FREDRIC
Middle Name:
Last Name:HABERMAN
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 1:50 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-4843
Mailing Address - Country:US
Mailing Address - Phone:201-368-0011
Mailing Address - Fax:201-368-2380
Practice Address - Street 1:50 MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-4843
Practice Address - Country:US
Practice Address - Phone:201-368-0011
Practice Address - Fax:201-368-2380
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB2222353207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology