Individual provider Active NPI

Irene C Haralabatos, M.D.

  • Allergy & Immunology Physician
  • Philadelphia, PA
National Provider Identifier
1386792430
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD060935L Issued in PA
Practice address
205 N Broad St
Suite 300
Philadelphia, PA 19107-1554
Phone
(215) 569-1111
Fax
(215) 569-8797
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD060935L PA Primary
Allergy & Immunology Physician 207K00000X 25MA06891700 NJ

Addresses

Primary practice location

205 N Broad St
Suite 300
Philadelphia, PA 19107-1554

Mailing address

205 N Broad St
Suite 300
Philadelphia, PA 19107-1554
Phone (215) 569-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101123001086 PA Practitioner - Allergy/Immunology 0547456071 Reassigns benefits to 1 organization
I20230105001554 NJ Practitioner - Allergy/Immunology 0547456071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allergic Disease Associates PC Allergy & Immunology CurrentSince Oct 17, 1998 Accepting new patients
Allergy and Asthma Specialty Physicians, LLC Allergy & Immunology PastSince Mar 1, 2020 Accepting new patients

Locations

2059 Briggs Rd
Ste 306
Mount Laurel, NJ 08054
Phone (856) 316-0300

404 Middletown Blvd
Ste 305
Langhorne, PA 19047
Phone (215) 750-7040

2137 Welsh Rd
Ste 2B
Philadelphia, PA 19115
Phone (215) 667-4433

822 Pine St
Ste 1D
Philadelphia, PA 19107
Phone (215) 922-5080

205 N Broad St
Ste 300
Philadelphia, PA 19107
Phone (215) 569-1111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1386792430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-569-1111",
            "fax_number": "215-569-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-569-1111",
            "fax_number": "215-569-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARALABATOS",
        "first_name": "IRENE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "MD060935L",
            "primary": true
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA06891700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.