Healthcare Provider Details

I. General information

NPI: 1780262295
Provider Name (Legal Business Name): DANA J HARIRI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

IV. Provider business mailing address

750 E ADAMS ST RM 3704
SYRACUSE NY
13210-2306
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-4750
  • Fax: 315-464-7130
Mailing address:
  • Phone: 315-464-2306
  • Fax: 315-464-9385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number343499
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: