Healthcare Provider Details

I. General information

NPI: 1649270976
Provider Name (Legal Business Name): SAAD F HABBA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 03/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 BANK ST SUITE 102
SUMMIT NJ
07901-3610
US

IV. Provider business mailing address

12 BANK ST SUITE 102
SUMMIT NJ
07901-3610
US

V. Phone/Fax

Practice location:
  • Phone: 908-273-3434
  • Fax: 908-273-3210
Mailing address:
  • Phone: 908-273-3434
  • Fax: 908-273-3210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMA44556
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: