Provider Demographics
NPI:1811122559
Name:HARVEY, EUGENIUS JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:EUGENIUS
Middle Name:JOHN
Last Name:HARVEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 95000-4990
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-4990
Mailing Address - Country:US
Mailing Address - Phone:212-636-1000
Mailing Address - Fax:212-523-2351
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:4W BABCOCK - INST. OF BARIATRIC & MIN. INVASIVE SURGERY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-636-1000
Practice Address - Fax:212-523-2351
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY253216208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03121184Medicaid
NYA400014545Medicare PIN