Provider Demographics
NPI:1043761836
Name:HARBERT, CAROLINA LEONID (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:LEONID
Last Name:HARBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-5503
Mailing Address - Fax:717-798-3510
Practice Address - Street 1:1695 ROOSEVELT AVE STE B
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-8521
Practice Address - Country:US
Practice Address - Phone:717-851-5503
Practice Address - Fax:717-798-3510
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4739172084N0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program