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NPI Code Detail

MEDICARE: DR. CRAIG MICHAEL HAEN PH.D, RDT, CGP, LCAT

MEDICARE: DR. CRAIG MICHAEL HAEN PH.D, RDT, CGP, LCAT
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
1221700000XArt Therapist000656NY

General Provider Information

NPI Number : 1548598600
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRAIG MICHAEL HAEN PH.D, RDT, CGP, LCAT
Provider Business Mailing Address
First Line : 510 N BROADWAY
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10603-3217
Country : US
Telephone Number : 917-439-7892
Fax Number :
Provider Business Practice Location Address
First Line : 510 N BROADWAY
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10603-3217
Country : US
Telephone Number : 917-439-7892
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2009
Last Update Date : 01/13/2016

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