Provider Demographics
NPI:1386729374
Name:HAROON, MUNEEB U (MD)
Entity type:Individual
Prefix:DR
First Name:MUNEEB
Middle Name:U
Last Name:HAROON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 DAVISON RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-5228
Mailing Address - Country:US
Mailing Address - Phone:716-434-6248
Mailing Address - Fax:716-438-0012
Practice Address - Street 1:822 DAVISON RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-5228
Practice Address - Country:US
Practice Address - Phone:716-434-6248
Practice Address - Fax:716-438-0012
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168765207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01000215Medicaid
NYA77132Medicare UPIN
NYDD0642Medicare PIN