Provider Demographics
NPI:1083708523
Name:HARO, IBRAHIM (DPM)
Entity Type:Individual
Prefix:DR
First Name:IBRAHIM
Middle Name:
Last Name:HARO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 CLIFTON AVE
Mailing Address - Street 2:105
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013
Mailing Address - Country:US
Mailing Address - Phone:973-777-5771
Mailing Address - Fax:973-777-8229
Practice Address - Street 1:1005 CLIFTON AVE
Practice Address - Street 2:105
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013
Practice Address - Country:US
Practice Address - Phone:973-777-5771
Practice Address - Fax:973-777-8229
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00260400213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ841652160OtherQUALCARE
NJ010004607-02OtherAMERICHOICE OF NJ
NJ9647690OtherGHI
NJ010004607-00OtherAMERICHOICE OF NJ
NJ841652160OtherUNITED HEALTH CARE
NJ1156209OtherHORIZON NJ HEALTH
NJ1431234OtherAMERIHEALTH
NJ841652160OtherBLUE CROSS BLUE SHEILD
NJP2530146OtherOXFORD
NJ8641102Medicaid
NJ0450694003OtherCIGNA
NJP00110397OtherRAILROAD MEDICARE
NJ2116157000OtherAMERIHEALTH
NJ2K8060OtherHEALTH NET
NJ0450694003OtherCIGNA
NJP2530146OtherOXFORD
NJ841652160OtherBLUE CROSS BLUE SHEILD
NJ841652160OtherUNITED HEALTH CARE