Provider Demographics
NPI:1215908298
Name:HAIKIM, RENEE M (PT)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:M
Last Name:HAIKIM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:M
Other - Last Name:BENKASKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:435 SCRANTON CARBONDALE HWY
Mailing Address - Street 2:VIEWMONT MEDICAL SERVICES
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508
Mailing Address - Country:US
Mailing Address - Phone:570-343-4334
Mailing Address - Fax:
Practice Address - Street 1:435 SCRANTON CARBONDALE HWY
Practice Address - Street 2:VIEWMONT MEDICAL SERVICES
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508
Practice Address - Country:US
Practice Address - Phone:570-343-4334
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007045L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P63606Medicare UPIN
PA059627Medicare ID - Type Unspecified