Basic Information
| Provider Information | |||||||||
| NPI: | 1427036227 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARASIMOWICZ | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5655 HUDSON DR STE 210 | ||||||||
| Address2: | ARIS RADIOLOGY | ||||||||
| City: | HUDSON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442364455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306551869 | ||||||||
| FaxNumber: | 3306553828 | ||||||||
| Practice Location | |||||||||
| Address1: | 5655 HUDSON DR STE 210 | ||||||||
| Address2: | ARIS RADIOLOGY | ||||||||
| City: | HUDSON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442364455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306551869 | ||||||||
| FaxNumber: | 3306553828 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2006 | ||||||||
| LastUpdateDate: | 11/09/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | ME0054418 | FL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 01055947A | IN | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 041575 | GA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | SSN | 01 | GA | CHAMPUS TRICARE | OTHER | 000701225C | 05 | GA | MEDICAID | 336573 | 01 | GA | WELLCARE | OTHER | 52506963002 | 01 | GA | BCBS OF GEORGIA | OTHER | P00186687 | 01 | GA | RR MEDICARE | OTHER | 009974705 | 05 | AL | MEDICAID | 60034229 | 01 | AL | BCBS OF ALABAMA | OTHER |