Provider Demographics
NPI:1184104994
Name:WILLOR, HABIBA
Entity type:Individual
Prefix:MISS
First Name:HABIBA
Middle Name:
Last Name:WILLOR
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 1:1228 VETERANS HWY APT G1
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19056-1607
Mailing Address - Country:US
Mailing Address - Phone:267-467-9894
Mailing Address - Fax:215-302-0287
Practice Address - Street 1:1228 VETERANS HWY APT G1
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-1607
Practice Address - Country:US
Practice Address - Phone:267-467-9894
Practice Address - Fax:215-302-0287
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA830742066Medicaid