Provider Demographics
NPI:1134523780
Name:GEORGE HARB
Entity type:Organization
Organization Name:GEORGE HARB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ELIAS
Authorized Official - Last Name:HARB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-509-6567
Mailing Address - Street 1:70 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4910
Mailing Address - Country:US
Mailing Address - Phone:973-994-4738
Mailing Address - Fax:
Practice Address - Street 1:148 PARK ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2909
Practice Address - Country:US
Practice Address - Phone:973-509-6567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEORGE HARB
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-10
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06101100261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care