Individual
DR. OLIVIA HABACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9016 SUTPHIN BLVD, JAMAICA, NY 11435-3636
(718) 523-5500
(718) 658-8260
Mailing address
80 MARCUS DR, MELVILLE, NY 11747-4230
(631) 391-8366
(631) 454-4163
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
142245
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00564627
—
NY
Enumeration date
10/25/2006
Last updated
01/18/2013
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