Provider Demographics
NPI:1699582007
Name:HARKABUS, DANIEL J JR (COA, OSA)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:HARKABUS
Suffix:JR
Gender:M
Credentials:COA, OSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MANOR HILL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1538
Mailing Address - Country:US
Mailing Address - Phone:330-533-8851
Mailing Address - Fax:
Practice Address - Street 1:45 MANOR HILL DR STE 200
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-1538
Practice Address - Country:US
Practice Address - Phone:330-533-8851
Practice Address - Fax:330-533-8930
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
326188246ZC0007X, 156FX1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant