Provider Demographics
NPI:1598326167
Name:PAPAHARIS, JONATHAN (CRNP)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:PAPAHARIS
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:JONATHAN
Other - Middle Name:
Other - Last Name:PAPAHARIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:1634 MONTROSE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2012
Mailing Address - Country:US
Mailing Address - Phone:203-979-3179
Mailing Address - Fax:
Practice Address - Street 1:1600 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5008
Practice Address - Country:US
Practice Address - Phone:610-327-7522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020413363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily