Provider Demographics
NPI:1558332288
Name:HARVEY, MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:HARVEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1008
Mailing Address - Country:US
Mailing Address - Phone:516-622-6000
Mailing Address - Fax:516-608-2889
Practice Address - Street 1:2 PRO HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1111
Practice Address - Country:US
Practice Address - Phone:516-622-6800
Practice Address - Fax:516-622-6801
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139074207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY81A011Medicare ID - Type Unspecified
NYB79573Medicare UPIN