Provider Demographics
NPI:1215571450
Name:HARBOR VIEW MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:HARBOR VIEW MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT VP
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:IADANZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-686-7830
Mailing Address - Street 1:100 HIGHLANDS BLVD # 9
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2320
Mailing Address - Country:US
Mailing Address - Phone:631-686-7890
Mailing Address - Fax:
Practice Address - Street 1:70 N COUNTRY RD STE 102
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2161
Practice Address - Country:US
Practice Address - Phone:631-938-6999
Practice Address - Fax:631-938-6668
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARBOR VIEW MEDICAL SERVICES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-31
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty