Provider Demographics
NPI:1588752372
Name:HAARIS, ABSAR (DO)
Entity type:Individual
Prefix:DR
First Name:ABSAR
Middle Name:
Last Name:HAARIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21604 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3525
Mailing Address - Country:US
Mailing Address - Phone:718-465-3200
Mailing Address - Fax:718-465-9792
Practice Address - Street 1:21604 UNION TPKE
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3525
Practice Address - Country:US
Practice Address - Phone:718-465-3200
Practice Address - Fax:718-465-9792
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217456174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02232180Medicaid
NY02232180Medicaid
NYH21565Medicare UPIN