Provider Demographics
NPI:1245242304
Name:DR. CHERYL HAAG & ASSOCIATES
Entity Type:Organization
Organization Name:DR. CHERYL HAAG & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAAG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-675-2111
Mailing Address - Street 1:100 W MONUMENT AVE
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-1804
Mailing Address - Country:US
Mailing Address - Phone:215-672-2111
Mailing Address - Fax:
Practice Address - Street 1:100 W MONUMENT AVE
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-1804
Practice Address - Country:US
Practice Address - Phone:215-672-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002120-L213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT28764Medicare UPIN
PA110736Medicare ID - Type Unspecified