Provider Demographics
NPI:1063688653
Name:HALUSHKA, ANDREW TARAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:TARAS
Last Name:HALUSHKA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 SECOND STREET PIKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3831
Mailing Address - Country:US
Mailing Address - Phone:215-322-1880
Mailing Address - Fax:215-396-0381
Practice Address - Street 1:347 SECOND STREET PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3831
Practice Address - Country:US
Practice Address - Phone:215-322-1880
Practice Address - Fax:215-396-0381
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005992L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor