Provider Demographics
NPI:1851506737
Name:HARNIK, IAN G (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:G
Last Name:HARNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 HENRY HUDSON PKWY
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3224
Mailing Address - Country:US
Mailing Address - Phone:718-796-1000
Mailing Address - Fax:718-796-2124
Practice Address - Street 1:3333 HENRY HUDSON PKWY
Practice Address - Street 2:SUITE #1
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3224
Practice Address - Country:US
Practice Address - Phone:718-796-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239608207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY239608OtherNY STATE LICENSE