Healthcare Provider Details

I. General information

NPI: 1811953938
Provider Name (Legal Business Name): DAVID HARAKAL O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 HOWERTOWN RD
CATASAUQUA PA
18032-1615
US

IV. Provider business mailing address

3129 OXFORD CIR S
ALLENTOWN PA
18104-2840
US

V. Phone/Fax

Practice location:
  • Phone: 610-264-4664
  • Fax: 610-264-5202
Mailing address:
  • Phone: 610-395-9242
  • Fax: 610-395-9242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG 000181
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: