Provider Demographics
NPI:1023395530
Name:HABERLEY, STEVEN (LPN)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:HABERLEY
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 BUNTS RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-6102
Mailing Address - Country:US
Mailing Address - Phone:216-970-6271
Mailing Address - Fax:
Practice Address - Street 1:2040 BUNTS RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-6102
Practice Address - Country:US
Practice Address - Phone:216-970-6271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH145565164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse