Healthcare Provider Details

I. General information

NPI: 1699582007
Provider Name (Legal Business Name): DANIEL J. HARKABUS JR. COA, OSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DJ HARKABUS JR. COA, OSA

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 MANOR HILL DR STE 200
CANFIELD OH
44406-1538
US

IV. Provider business mailing address

45 MANOR HILL DR STE 200
CANFIELD OH
44406-1538
US

V. Phone/Fax

Practice location:
  • Phone: 330-533-8851
  • Fax: 330-533-8930
Mailing address:
  • Phone: 330-533-8851
  • Fax: 330-533-8930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FX1101X
TaxonomyOphthalmic Assistant
License Number326188
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number326188
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: