Provider Demographics
NPI:1750595427
Name:RAY A HAAG,MD PC
Entity type:Organization
Organization Name:RAY A HAAG,MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR.
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-224-8533
Mailing Address - Street 1:1948 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-7920
Mailing Address - Country:US
Mailing Address - Phone:631-968-8989
Mailing Address - Fax:
Practice Address - Street 1:1948 UNION BLVD
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-7920
Practice Address - Country:US
Practice Address - Phone:631-968-8989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEH511Medicare ID - Type Unspecified