Provider Demographics
NPI:1740253186
Name:GORRIN, HARVEY D (MD)
Entity type:Individual
Prefix:
First Name:HARVEY
Middle Name:D
Last Name:GORRIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:MT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-666-6448
Mailing Address - Fax:914-242-3718
Practice Address - Street 1:15 MOORE AVE
Practice Address - Street 2:
Practice Address - City:MT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-666-6448
Practice Address - Fax:914-242-3718
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113205207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B20561Medicare UPIN
NY967491Medicare PIN