Provider Demographics
NPI:1538316419
Name:JOHN T. HARETOS, M.D.
Entity Type:Organization
Organization Name:JOHN T. HARETOS, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-621-3431
Mailing Address - Street 1:160 N CRAIG ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2716
Mailing Address - Country:US
Mailing Address - Phone:412-621-3431
Mailing Address - Fax:
Practice Address - Street 1:160 N CRAIG ST
Practice Address - Street 2:SUITE 114
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2716
Practice Address - Country:US
Practice Address - Phone:412-621-3431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028204E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001006134Medicaid
PA001006134Medicaid