Healthcare Provider Details

I. General information

NPI: 1033643861
Provider Name (Legal Business Name): JASMIN HAROUNIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SUMMIT AVE
ELMWOOD PARK NJ
07407-1529
US

IV. Provider business mailing address

9 SUMMIT AVE
ELMWOOD PARK NJ
07407-1529
US

V. Phone/Fax

Practice location:
  • Phone: 201-458-1080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number25MA11533600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number311060
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: