Provider Demographics
NPI:1063402584
Name:HARP, DJANA (MD)
Entity type:Individual
Prefix:MS
First Name:DJANA
Middle Name:
Last Name:HARP
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 1:46 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06605-2602
Mailing Address - Country:US
Mailing Address - Phone:203-330-6000
Mailing Address - Fax:203-330-6008
Practice Address - Street 1:510 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06605-1701
Practice Address - Country:US
Practice Address - Phone:203-330-6000
Practice Address - Fax:203-382-2954
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056457207V00000X
CT55781207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA16BBCVRMedicare ID - Type Unspecified
I39560Medicare UPIN