Provider Demographics
NPI:1851898522
Name:ATHREYA, HARIHARAN (MD)
Entity type:Individual
Prefix:DR
First Name:HARIHARAN
Middle Name:
Last Name:ATHREYA
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 1:756 ELBERT ST SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-2852
Mailing Address - Country:US
Mailing Address - Phone:210-620-3172
Mailing Address - Fax:
Practice Address - Street 1:148 E 38TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2607
Practice Address - Country:US
Practice Address - Phone:833-955-3592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA88846207Q00000X
NY1043889967261QM2500X
CT1992372403261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty