Individual provider Active NPI

Steven M Haber

  • Dentist
  • Fort Lee, NJ
National Provider Identifier
1104834001
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11831 Issued in NJ
Practice address
1319 Anderson Ave
Office C
Fort Lee, NJ 07024-1734
Phone
(201) 224-0094
Fax
(201) 224-0095
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11831 NJ Primary
Dentist 122300000X 0311221 NY

Addresses

Primary practice location

1319 Anderson Ave
Office C
Fort Lee, NJ 07024-1734

Mailing address

1319 Anderson Ave
Office C
Fort Lee, NJ 07024-1734
Phone (201) 224-0094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180919000453 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2668690710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11831NJMDDentist
0311221NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104834001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 ANDERSON AVE",
            "address_2": "OFFICE C",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241734",
            "telephone_number": "201-224-0094",
            "fax_number": "201-224-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 ANDERSON AVE",
            "address_2": "OFFICE C",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241734",
            "telephone_number": "201-224-0094",
            "fax_number": "201-224-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABER",
        "first_name": "STEVEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "11831",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0311221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.