Individual provider Active NPI

Marc Haber, PT

  • Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1558501593
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5680 Issued in NY
Practice address
10210 66TH Rd
Forest Hills, NY 11375-2000
Phone
(516) 241-6651
NPI assigned
Mar 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5680 NY Primary

Addresses

Primary practice location

10210 66TH Rd
Forest Hills, NY 11375-2000

Mailing address

10210 66TH Rd
Forest Hills, NY 11375-2000
Phone (516) 241-6651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5680NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1558501593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10210 66TH RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752000",
            "telephone_number": "516-241-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10210 66TH RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752000",
            "telephone_number": "516-241-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABER",
        "first_name": "MARC",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "5680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.