Provider Demographics
NPI:1558542134
Name:HABINEZA, MAURICE (PT,DPT,MSPT)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:
Last Name:HABINEZA
Suffix:
Gender:M
Credentials:PT,DPT,MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2114
Mailing Address - Country:US
Mailing Address - Phone:412-369-9955
Mailing Address - Fax:412-369-5959
Practice Address - Street 1:1105 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2114
Practice Address - Country:US
Practice Address - Phone:412-369-9955
Practice Address - Fax:412-369-5959
Is Sole Proprietor?:No
Enumeration Date:2007-11-24
Last Update Date:2007-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017411225100000X
WVPT 002486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist