Individual
DIANE LOIS HABER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RN, CS
Contact information
Practice address
5331 MARATHON PKWY, DOUGLASTON, NY 11362-1720
(718) 224-5235
(718) 224-9498
Mailing address
5846 246TH CRES, 58-46 246 CRESCENT, DOUGLASTON, NY 11362-2028
(718) 224-5235
(718) 224-9498
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
148362-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107748
MHN
NY
01
—
13870
VALUE OPTIONS
NY
01
—
1483626822
HIP
NV
01
—
7369085
MAGELLAN
NY
01
—
R0081
BLUE CROSS
—
Enumeration date
11/12/2006
Last updated
05/26/2010
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