MEDICARE: HARLAN EDWARD HIRAMOTO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	25MA03970900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	651185842	OTHER	NJ	TID
2	4223397	OTHER	NJ	AETNA

General Provider Information

NPI Number	:	1528061975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARLAN EDWARD HIRAMOTO MD

Provider Business Mailing Address
First Line	:	465 UNION AVE
Second Line	:	SUITE C BRIDGEWATER MEDICAL COMPLEX
City	:	BRIDGEWATER
State	:	NJ
Zip	:	08807-3196
Country	:	US
Telephone Number	:	908-429-7600
Fax Number	:	908-429-7960

Provider Business Practice Location Address
First Line	:	465 UNION AVE
Second Line	:	SUITE C
City	:	BRIDGEWATER
State	:	NJ
Zip	:	08807-3196
Country	:	US
Telephone Number	:	908-429-7600
Fax Number	:	908-429-7960

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	03/06/2014

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