Provider Demographics
NPI:1538211636
Name:HABER, CONSTANCE D (DC)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:D
Last Name:HABER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 MOSSIDE BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3576
Mailing Address - Country:US
Mailing Address - Phone:412-372-7900
Mailing Address - Fax:412-372-7911
Practice Address - Street 1:2571 MOSSIDE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3576
Practice Address - Country:US
Practice Address - Phone:412-372-7900
Practice Address - Fax:412-372-7911
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA001169L111NT0100X, 111NX0800X
PADC-001169-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NT0100XChiropractic ProvidersChiropractorThermography
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00631206Medicaid
PA112589Medicare PIN
PA00631206Medicaid
PA00631206Medicaid