MEDICARE: MOIRA ANN HAREN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50-001341	OH
2	363A00000X	Physician Assistant	50.001341	OH

General Provider Information

NPI Number	:	1740345032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOIRA ANN HAREN PA

Provider Business Mailing Address
First Line	:	4900 BABSON PLACE
Second Line	:	SUITE 600
City	:	CINCINNATI
State	:	OH
Zip	:	45272-2636
Country	:	US
Telephone Number	:	513-272-8444
Fax Number	:	513-272-0015

Provider Business Practice Location Address
First Line	:	4900 BABSON PLACE
Second Line	:	SUITE 600
City	:	CINCINNATI
State	:	OH
Zip	:	45272-2636
Country	:	US
Telephone Number	:	513-272-8444
Fax Number	:	513-272-0015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	10/06/2011

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Directions to “ MOIRA ANN HAREN PA” Practice Location

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