Provider Demographics
NPI:1093028961
Name:HAAS, ERIC D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:D
Last Name:HAAS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 WOODBINE RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3057
Mailing Address - Country:US
Mailing Address - Phone:610-269-2600
Mailing Address - Fax:610-873-8028
Practice Address - Street 1:151 WOODBINE RD
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3057
Practice Address - Country:US
Practice Address - Phone:610-269-2600
Practice Address - Fax:610-873-8028
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015045103G00000X, 103TC0700X
DEB1-0000722103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist