Provider Demographics
NPI:1255741153
Name:HARBOR VIEW MEDICAL SERVICES PC
Entity type:Organization
Organization Name:HARBOR VIEW MEDICAL SERVICES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FARO
Authorized Official - Suffix:
Authorized Official - Credentials:CMO
Authorized Official - Phone:631-476-2866
Mailing Address - Street 1:4 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-4080
Mailing Address - Country:US
Mailing Address - Phone:631-246-8289
Mailing Address - Fax:631-246-8294
Practice Address - Street 1:4 TECHNOLOGY DR
Practice Address - Street 2:SUITE 120
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-4080
Practice Address - Country:US
Practice Address - Phone:631-686-7890
Practice Address - Fax:631-246-8294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty