1427036227 NPI number — JOSEPH A HARASIMOWICZ JR. MD

Table of content: JOSEPH A HARASIMOWICZ JR. MD (NPI 1427036227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427036227 NPI number — JOSEPH A HARASIMOWICZ JR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARASIMOWICZ
Provider First Name:
JOSEPH
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427036227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5655 HUDSON DR STE 210
Provider Second Line Business Mailing Address:
ARIS RADIOLOGY
Provider Business Mailing Address City Name:
HUDSON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44236-4455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-655-1869
Provider Business Mailing Address Fax Number:
330-655-3828

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5655 HUDSON DR STE 210
Provider Second Line Business Practice Location Address:
ARIS RADIOLOGY
Provider Business Practice Location Address City Name:
HUDSON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44236-4455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-655-1869
Provider Business Practice Location Address Fax Number:
330-655-3828
Provider Enumeration Date:
01/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  ME0054418 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0202X , with the licence number: 01055947A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 041575 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SSN . This is a "CHAMPUS TRICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 000701225C , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 336573 . This is a "WELLCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 52506963002 . This is a "BCBS OF GEORGIA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: P00186687 . This is a "RR MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 009974705 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 60034229 . This is a "BCBS OF ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".