Provider Demographics
NPI:1306437264
Name:HABER, JUDITH SAMARA
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:SAMARA
Last Name:HABER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FILLMORE ST STE LL02
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4916
Mailing Address - Country:US
Mailing Address - Phone:303-322-7507
Mailing Address - Fax:
Practice Address - Street 1:100 FILLMORE ST STE LL02
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4916
Practice Address - Country:US
Practice Address - Phone:303-322-7507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician