Provider Demographics
NPI:1881144640
Name:HARVIN, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:HARVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16319 130TH AVE
Mailing Address - Street 2:APT 11A
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3046
Mailing Address - Country:US
Mailing Address - Phone:646-634-9084
Mailing Address - Fax:
Practice Address - Street 1:16319 130TH AVE
Practice Address - Street 2:APT 11A
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3046
Practice Address - Country:US
Practice Address - Phone:646-634-9084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker