Provider Demographics
NPI:1982205894
Name:HAROLD FLOCKHART ADULT HEALTH NP PC
Entity Type:Organization
Organization Name:HAROLD FLOCKHART ADULT HEALTH NP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FLOCKHART
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:631-521-1683
Mailing Address - Street 1:12 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1149
Mailing Address - Country:US
Mailing Address - Phone:631-521-1683
Mailing Address - Fax:
Practice Address - Street 1:12 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1149
Practice Address - Country:US
Practice Address - Phone:631-521-1683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty