Provider Demographics
NPI:1295713634
Name:MCGURK, HARRIET E (MD)
Entity type:Individual
Prefix:DR
First Name:HARRIET
Middle Name:E
Last Name:MCGURK
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:630 W 168TH ST
Mailing Address - Street 2:CH 517 CHILDRENS HOSPITAL OF NY DEPT PEDIATRICS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-342-3060
Mailing Address - Fax:212-342-6010
Practice Address - Street 1:630 W 168TH ST
Practice Address - Street 2:CH 517 CHILDRENS HOSP OF NY DEPT PEDIATRICS
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-342-3060
Practice Address - Fax:212-342-6010
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY121259208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00671485Medicaid
NY456Y41Medicare ID - Type Unspecified
NY00671485Medicaid