Provider Demographics
NPI:1801029384
Name:HARTER, JOSEPH PATRICK
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:HARTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0 GOVERNORS AVE
Mailing Address - Street 2:B6
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3025
Mailing Address - Country:US
Mailing Address - Phone:781-391-1484
Mailing Address - Fax:781-391-1432
Practice Address - Street 1:0 GOVERNORS AVE
Practice Address - Street 2:B6
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3025
Practice Address - Country:US
Practice Address - Phone:781-391-1484
Practice Address - Fax:781-391-1432
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242587171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist