Provider Demographics
NPI:1245302702
Name:HARALSON, BARBARA B (MD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:B
Last Name:HARALSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CADMAN PLAZA WEST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:929-210-6000
Mailing Address - Fax:929-210-6001
Practice Address - Street 1:300 CADMAN PLAZA WEST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:929-210-6000
Practice Address - Fax:929-210-6001
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238549-1207PE0004X
NY238549207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00420638OtherRRM LEGACY
NY02741275Medicaid
NYP00420638OtherRRM LEGACY
NYA400090988Medicare PIN