Individual provider Active NPI

Harold Ronald Haraldsen Jr., DC

  • Chiropractor
  • East Stroudsburg, PA
National Provider Identifier
1790892909
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC006462L Issued in PA
Practice address
8 Fox Run Lane
East Stroudsburg, PA 18301
Phone
(570) 223-1650
Fax
(570) 223-8235
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC006462L PA Primary

Addresses

Primary practice location

8 Fox Run Lane
East Stroudsburg, PA 18301

Mailing address

8 Fox Run Lane
East Stroudsburg, PA 18301
Phone (570) 223-1650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110126000750 PA Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 1951580687 Practice locations: East Stroudsburg, PA

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Life Chiropractic College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

247 Fox Run Lane
Suite 101
East Stroudsburg, PA 18302-9246

247 Fox Run LN
Suite 101
East Stroudsburg, PA 18302-9612
Phone (570) 223-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790892909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FOX RUN LANE",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-223-1650",
            "fax_number": "570-223-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 FOX RUN LANE",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-223-1650",
            "fax_number": "570-223-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARALDSEN",
        "first_name": "HAROLD",
        "middle_name": "RONALD",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006462L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.