Organization Active NPI

Laurence D. Haber, M.D., P.C.

  • Neurology Physician
  • Great Neck, NY
National Provider Identifier
1336393685
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
169382-1 Issued in NY
Legal business name
LAURENCE D. HABER, M.D., P.C.
Practice address
1000 Northern Blvd Ste 110
Great Neck, NY 11021-5312
Phone
(516) 498-1122
Fax
(516) 466-6714
NPI assigned
Nov 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Authorized official

Name
Laurence D. Haber, MDNPI 1053319475
Title
Neurologist
Phone
(516) 498-1122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 169382-1 NY Primary

Addresses

Primary practice location

1000 Northern Blvd Ste 110
Great Neck, NY 11021-5312

Mailing address

1000 Northern Blvd Ste 110
Great Neck, NY 11021-5312
Phone (516) 498-1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050517000368 NY Part B Supplier - Clinic/Group Practice 3870534126 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manhasset, NY; Great Neck, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1000 Northern Blvd
Ste 110
Great Neck, NY 11021
Phone (516) 482-0302

Practitioners & affiliated clinicians

Practitioners 1

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": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1336393685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD STE 110",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215312",
            "telephone_number": "516-498-1122",
            "fax_number": "516-466-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD STE 110",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215312",
            "telephone_number": "516-498-1122",
            "fax_number": "516-466-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURENCE D. HABER, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "HABER",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "NEUROLOGIST",
        "authorized_official_telephone_number": "516-498-1122",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "169382-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.