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NPI Code Detail

MEDICARE: DR ANDREW M HARARAH DO PC MEDICAL C

MEDICARE: DR ANDREW M HARARAH DO PC MEDICAL C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1194917443
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR ANDREW M HARARAH DO PC MEDICAL C
Provider Business Mailing Address
First Line : 357 BROADWAY
Second Line :
City : AMITYVILLE
State : NY
Zip : 11701-2748
Country : US
Telephone Number : 631-789-7900
Fax Number :
Provider Business Practice Location Address
First Line : 357 BROADWAY
Second Line :
City : AMITYVILLE
State : NY
Zip : 11701-2748
Country : US
Telephone Number : 631-789-7900
Fax Number : 631-608-8492
Authorized Official
Title or Position : OFFICE MANAGER
Name : JOHN PFEIL
Credential : MA
Telephone Number : 631-789-7900
Provider Enumeration Date : 08/10/2007
Last Update Date : 02/14/2023

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