Basic Information
| Provider Information | |||||||||
| NPI: | 1831402635 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAROYAN | ||||||||
| FirstName: | HARUTYUN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2040 ARCH ST | ||||||||
| Address2: | NONE | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191031412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2672587073 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3401 CIVIC CENTER BLVD | ||||||||
| Address2: | DEPARTMENT OF RADIOLOGY | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155901000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2010 | ||||||||
| LastUpdateDate: | 07/16/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | L1553542 | MI | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085P0229X | MT207536 | PA | Y | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology |
No ID Information.