Provider Demographics
NPI:1386359305
Name:HABIB, SARRA S (RCS)
Entity type:Individual
Prefix:
First Name:SARRA
Middle Name:S
Last Name:HABIB
Suffix:
Gender:F
Credentials:RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:60 OLD STONE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1231
Mailing Address - Country:US
Mailing Address - Phone:201-310-6226
Mailing Address - Fax:
Practice Address - Street 1:60 OLD STONE CHURCH RD
Practice Address - Street 2:
Practice Address - City:UPPER SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-1231
Practice Address - Country:US
Practice Address - Phone:201-310-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJB7935463052085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound