MEDICARE: AMARA HABER M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1134458581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMARA HABER M.S.

Provider Business Mailing Address
First Line	:	4840 OGLE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19127-1905
Country	:	US
Telephone Number	:	609-760-2146
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 OLD EAGLE SCHOOL RD
Second Line	:
City	:	STRAFFORD
State	:	PA
Zip	:	19087-2556
Country	:	US
Telephone Number	:	609-760-2146
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2009
Last Update Date	:	12/14/2009

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