Individual
DR. TERESA AIMEE HABACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5954 ROUTE 25A, WADING RIVER, NY 11792-2001
(631) 473-4263
(631) 473-4260
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 473-4263
(631) 473-4260
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
184539
NY
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
184539
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02925937
—
NY
Enumeration date
10/13/2006
Last updated
11/17/2020
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