Provider Demographics
NPI:1881784213
Name:WINTERS, HARRY A (MD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:A
Last Name:WINTERS
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 1:26 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:EAST WILLISTON
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2007
Mailing Address - Country:US
Mailing Address - Phone:516-873-0904
Mailing Address - Fax:516-873-0904
Practice Address - Street 1:70 GLEN COVE RD
Practice Address - Street 2:SUITE 306
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1726
Practice Address - Country:US
Practice Address - Phone:516-621-7720
Practice Address - Fax:516-625-4521
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143712174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC07100Medicare UPIN
NY24E851Medicare ID - Type Unspecified