Provider Demographics
NPI:1497074702
Name:HABASH, ANDREW R (PT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:R
Last Name:HABASH
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Gender:M
Credentials:PT
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Mailing Address - Street 1:6480 HARRISON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-354-7785
Mailing Address - Fax:513-354-7651
Practice Address - Street 1:500 E BUSINESS WAY
Practice Address - Street 2:SUITE C
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2374
Practice Address - Country:US
Practice Address - Phone:513-389-3666
Practice Address - Fax:513-389-3665
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2015-06-09
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Provider Licenses
StateLicense IDTaxonomies
NC12646225100000X
OH0151622251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGOtherMEDICARE OHIO
NC0397730014Medicare NSC