Provider Demographics
NPI:1366528531
Name:HARAN, PAHIRATHI E (MD)
Entity type:Individual
Prefix:DR
First Name:PAHIRATHI
Middle Name:E
Last Name:HARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 BROADWAY
Mailing Address - Street 2:STE 200 B
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:973-627-3366
Mailing Address - Fax:973-539-2234
Practice Address - Street 1:76 BROADWAY
Practice Address - Street 2:STE 200 B
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:973-627-3366
Practice Address - Fax:973-539-5537
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0486392080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
871101OtherUHC
P621597OtherOXFORD
522156OtherAETNA
P621597OtherOXFORD