Provider Demographics
NPI:1255911913
Name:HAUER, LIBBY (SERVICE COORDINATOR)
Entity type:Individual
Prefix:
First Name:LIBBY
Middle Name:
Last Name:HAUER
Suffix:
Gender:F
Credentials:SERVICE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMASPIK WAY
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-8451
Mailing Address - Country:US
Mailing Address - Phone:845-500-3279
Mailing Address - Fax:
Practice Address - Street 1:1 HAMASPIK WAY
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-8451
Practice Address - Country:US
Practice Address - Phone:845-596-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty