Basic Information
Provider Information
NPI: 1467867267
EntityType: 2
ReplacementNPI:  
OrganizationName: HARBOR VIEW MEDICAL SERVICES, P.C.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: NEUROLOGY ASSOCIATES
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 70 N COUNTRY RD
Address2: SUITE 302
City: PORT JEFFERSON
State: NY
PostalCode: 117772161
CountryCode: US
TelephoneNumber: 6316867970
FaxNumber: 6316867831
Practice Location
Address1: 70 N COUNTRY RD
Address2: SUITE 302
City: PORT JEFFERSON
State: NY
PostalCode: 117772161
CountryCode: US
TelephoneNumber: 6316867890
FaxNumber: 6316867831
Other Information
ProviderEnumerationDate: 07/01/2014
LastUpdateDate: 09/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: FARO
AuthorizedOfficialFirstName: JOAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF MEDICAL OFFICER
AuthorizedOfficialTelephone: 6314731320
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.,
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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