Physician Compare National (NPI:1790892909)

HEALTHCARE PROVIDER: HAROLD RONALD HARALDSEN JR. DC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1790892909
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1951580687
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110126000750
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HARALDSEN
	Individual professional last name
Provider First Name	HAROLD
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LIFE CHIROPRACTIC COLLEGE
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PHYSICAL MEDICINE AND REHABILITATION
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PHYSICAL MEDICINE AND REHABILITATION
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	247 FOX RUN LN
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	EAST STROUDSBURG
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	183029612
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5702231800
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y