Provider Demographics
NPI:1952445389
Name:HEFTER, HAROLD S (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:S
Last Name:HEFTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:135 ROCKAWAY TPKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1023
Mailing Address - Country:US
Mailing Address - Phone:516-371-1600
Mailing Address - Fax:516-371-1681
Practice Address - Street 1:135 ROCKAWAY TPKE
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1023
Practice Address - Country:US
Practice Address - Phone:516-371-1600
Practice Address - Fax:516-371-1681
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY151140207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
80A841Medicare ID - Type Unspecified
A64330Medicare UPIN