MEDICARE: DR. MANFRED HAUBEN M.D., M.P.H

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0901X	Public Health & General Preventive Medicine Physician	167358	NY

General Provider Information

NPI Number	:	1447483870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANFRED HAUBEN M.D., M.P.H

Provider Business Mailing Address
First Line	:	400 E 71ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-4808
Country	:	US
Telephone Number	:	212-573-1777
Fax Number	:	212-808-8679

Provider Business Practice Location Address
First Line	:	400 EAST 71ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-4808
Country	:	US
Telephone Number	:	212-573-1777
Fax Number	:	212-808-8679

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2009
Last Update Date	:	09/02/2009

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