Provider Demographics
NPI:1033320866
Name:HARVEY PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:HARVEY PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:603-436-7810
Mailing Address - Street 1:610 ISLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4216
Mailing Address - Country:US
Mailing Address - Phone:603-436-7810
Mailing Address - Fax:603-433-9509
Practice Address - Street 1:610 ISLINGTON ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4216
Practice Address - Country:US
Practice Address - Phone:603-436-7810
Practice Address - Fax:603-433-9509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30312773Medicaid