Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC-007439-L | PA |
NPI | 1225077480 |
---|---|
Provider Name | Dr. Michael John Haczela |
First Address | Monaca, PA 15061-2457 |
Second Address | Monaca, PA 15061-2457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 26/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000480588 | BLUE CROSS/BLUE SHIELD (01) | PA |
01787749 | (05) | PA |
1020801 | HEALTH AMERICA/HEALTH ASS (01) | PA |
302900 | UPMC HEALTH PLAN (01) | PA |
7058073 | CIGNA HEALTHCARE (01) | PA |
7059104 | AETNA (01) | PA |
U77554 | (02) | PA |