Healthcare Provider Details

I. General information

NPI: 1285253484
Provider Name (Legal Business Name): SHAWN ANTHONY HAUPT MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 TENTH AVENUE DEPARTMENT OF EMERGENCY MEDICINE
BROOKLYN NY
11219
US

IV. Provider business mailing address

802 TENTH AVENUE DEPARTMENT OF EMERGENCY MEDICINE
BROOKLYN NY
11219
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-6000
  • Fax: 718-635-7274
Mailing address:
  • Phone: 718-283-6000
  • Fax: 718-635-7274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number323062
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: