Healthcare Provider Details

I. General information

NPI: 1811297914
Provider Name (Legal Business Name): DEBORAH HOPE HAFTEL F.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2010
Last Update Date: 10/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 ASTRO PL
DIX HILLS NY
11746-5728
US

IV. Provider business mailing address

11 ASTRO PL
DIX HILLS NY
11746-5728
US

V. Phone/Fax

Practice location:
  • Phone: 631-470-3392
  • Fax:
Mailing address:
  • Phone: 631-470-3392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License Number333584
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number333584
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number333584
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: