Provider Demographics
NPI:1649910860
Name:HARLEY, DUMICHEL AMIR (MS)
Entity type:Individual
Prefix:
First Name:DUMICHEL
Middle Name:AMIR
Last Name:HARLEY
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 BRIDGEPOINTE PKWY APT 137
Mailing Address - Street 2:
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-5079
Mailing Address - Country:US
Mailing Address - Phone:201-753-2068
Mailing Address - Fax:
Practice Address - Street 1:15 PARKMAN ST # 812
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-5991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program