Provider Demographics
NPI:1609458017
Name:HAROLD JOSEPH MD
Entity Type:Organization
Organization Name:HAROLD JOSEPH MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHYSICIAN PRACTICE MANAGE
Authorized Official - Prefix:MS
Authorized Official - First Name:WINTERJANE
Authorized Official - Middle Name:MAMIE
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:CCPPM
Authorized Official - Phone:631-743-4044
Mailing Address - Street 1:46 ROUTE 25A STE 6
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2807
Mailing Address - Country:US
Mailing Address - Phone:631-743-4044
Mailing Address - Fax:631-675-1623
Practice Address - Street 1:46 ROUTE 25A STE 6
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2807
Practice Address - Country:US
Practice Address - Phone:631-743-4044
Practice Address - Fax:631-675-1623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty