Provider Demographics
NPI:1205900669
Name:JARKON, LIAT J (DO)
Entity type:Individual
Prefix:DR
First Name:LIAT
Middle Name:J
Last Name:JARKON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:151 W CARVER ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3352
Mailing Address - Country:US
Mailing Address - Phone:631-271-1988
Mailing Address - Fax:631-659-3255
Practice Address - Street 1:151 W CARVER ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3352
Practice Address - Country:US
Practice Address - Phone:631-271-1988
Practice Address - Fax:631-659-3255
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1777072084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry