Provider Demographics
NPI:1598394157
Name:HAFEY, CLAIRISSE MARCELLE
Entity Type:Individual
Prefix:
First Name:CLAIRISSE
Middle Name:MARCELLE
Last Name:HAFEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MAIN ST APT 604
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-8853
Mailing Address - Country:US
Mailing Address - Phone:860-866-8683
Mailing Address - Fax:
Practice Address - Street 1:GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-0001
Practice Address - Country:US
Practice Address - Phone:570-271-6211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program