Healthcare Provider Details

I. General information

NPI: 1205858404
Provider Name (Legal Business Name): DARAN HABER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RIVERVIEW PLZ
RED BANK NJ
07701-1864
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 732-714-2700
  • Fax: 732-358-0605
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA05138300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: