Provider Demographics
NPI: | 1316921448 |
---|---|
Name: | W.V. HARRER PROFESSIONAL ASSOCIATION |
Entity type: | Organization |
Organization Name: | W.V. HARRER PROFESSIONAL ASSOCIATION |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | WILLIAM |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HARRER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 610-459-3113 |
Mailing Address - Street 1: | 1001 BRIGGS RD |
Mailing Address - Street 2: | SUITE 210 |
Mailing Address - City: | MOUNT LAUREL |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08054-4100 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 856-231-4774 |
Mailing Address - Fax: | 856-231-9699 |
Practice Address - Street 1: | 1600 HADDON AVE |
Practice Address - Street 2: | |
Practice Address - City: | CAMDEN |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08103-3101 |
Practice Address - Country: | US |
Practice Address - Phone: | 610-459-3113 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-12-01 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 25MA02416800 | 207ZP0102X |
207ZB0001X, 207ZC0500X, 207ZD0900X, 207ZH0000X, 207ZI0100X, 207ZM0300X, 207ZN0500X, 207ZP0101X, 207ZP0104X, 207ZP0105X, 207ZP0213X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Not Answered | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Single Specialty |
Not Answered | 207ZB0001X | Allopathic & Osteopathic Physicians | Pathology | Blood Banking & Transfusion Medicine | Group - Single Specialty |
Not Answered | 207ZC0500X | Allopathic & Osteopathic Physicians | Pathology | Cytopathology | Group - Single Specialty |
Not Answered | 207ZD0900X | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | Group - Single Specialty |
Not Answered | 207ZH0000X | Allopathic & Osteopathic Physicians | Pathology | Hematology | Group - Single Specialty |
Not Answered | 207ZI0100X | Allopathic & Osteopathic Physicians | Pathology | Immunopathology | Group - Single Specialty |
Not Answered | 207ZM0300X | Allopathic & Osteopathic Physicians | Pathology | Medical Microbiology | Group - Single Specialty |
Not Answered | 207ZN0500X | Allopathic & Osteopathic Physicians | Pathology | Neuropathology | Group - Single Specialty |
Not Answered | 207ZP0101X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | Group - Single Specialty |
Not Answered | 207ZP0104X | Allopathic & Osteopathic Physicians | Pathology | Chemical Pathology | Group - Single Specialty |
Not Answered | 207ZP0105X | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine | Group - Single Specialty |
Not Answered | 207ZP0213X | Allopathic & Osteopathic Physicians | Pathology | Pediatric Pathology | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | 2633701 | Medicaid | |
NJ | 470858 | Medicare ID - Type Unspecified |