Provider Demographics
NPI:1457527558
Name:HAUPTMAN, JONATHAN BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:BRIAN
Last Name:HAUPTMAN
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 1:666 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1227
Mailing Address - Country:US
Mailing Address - Phone:201-652-3397
Mailing Address - Fax:
Practice Address - Street 1:666 N MONROE ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1227
Practice Address - Country:US
Practice Address - Phone:201-652-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03856800207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism