Provider Demographics
NPI:1316996093
Name:HAFT, JACOB I (MD)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:I
Last Name:HAFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 BERKELEY DR
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1202
Mailing Address - Country:US
Mailing Address - Phone:201-343-8505
Mailing Address - Fax:201-569-4342
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 719
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1997
Practice Address - Country:US
Practice Address - Phone:201-343-8505
Practice Address - Fax:201-569-4342
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA024847207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Not Answered207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1157400Medicaid
NJ1157400Medicaid
NJHA450305Medicare ID - Type Unspecified