Organization Active NPI

Haven Family Medicine, P.C.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1003503392
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HAVEN FAMILY MEDICINE, P.C.
Practice address
707 W 171St St Ste W
New York, NY 10032-2811
Phone
(212) 927-3232
Fax
(212) 927-4571
NPI assigned
Apr 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Roberto Moran, MD
Title
Owner
Phone
(718) 902-2244

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

707 W 171St St Ste W
New York, NY 10032-2811

Mailing address

707 W 171St St Ste W
New York, NY 10032-2811
Phone (212) 927-3232

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1003503392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W 171ST ST STE W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322811",
            "telephone_number": "212-927-3232",
            "fax_number": "212-927-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W 171ST ST STE W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322811",
            "telephone_number": "212-927-3232",
            "fax_number": "212-927-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-18",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-902-2244",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.