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General NPI Number Information
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NPI Number | 1518480441
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Entity Type | Individual
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Provider Name | JOHN HARASZKIEWICZ
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Gender | Male
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Dates
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Enumeration Date | 07/23/2017
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Last Update Date | 07/23/2017
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Provider Practice Location Address
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Address Line | 1 COLLEGE CIR
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City | BANGOR
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State | ME
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Zip | 04401-2929
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Country | US
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Telephone | 517-612-5118
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Fax |
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Provider Business Mailing Address
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Address Line | 200 HANCOCK ST APT 509
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City | BANGOR
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State | ME
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Zip | 04401-6587
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Country | US
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Telephone | 517-612-5118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | PI45592
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License Number State | ME
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