| Professional Corporation | |
|
2 Academy Ln Bellport NY 11713-2702 | |
| (631) 286-3572 | |
| Not Available |
| Full Name | Professional Corporation |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2 Academy Ln, Bellport, New York |
| Authorized Official Name and Position | Joseph Arthur Harder (INDIVIDUAL PRACTITIONER) |
| Authorized Official Contact | 6312863572 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Corporation 2 Academy Ln Bellport NY 11713-2702 Ph: (631) 286-3572 | Professional Corporation 2 Academy Ln Bellport NY 11713-2702 Ph: (631) 286-3572 |
| NPI Number | 1508216185 |
|---|---|
| Provider Enumeration Date | 06/15/2016 |
| Last Update Date | 06/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508216185 | NPI | - | NPPES |
| 0704871 | Other | NY | INDIVIDUAL PRACTITIONER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0704871 (New York) | Primary |
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