MEDICARE: MICHAEL DAVID HARGROVE M.D.

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
1	2084P0800X	Psychiatry Physician	188349	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336114115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DAVID HARGROVE M.D.

Provider Business Mailing Address
First Line	:	17 MERLIN AVENUE
Second Line	:
City	:	SLEEPY HOLLOW
State	:	NY
Zip	:	10591-1606
Country	:	US
Telephone Number	:	914-490-8568
Fax Number	:	718-933-8208

Provider Business Practice Location Address
First Line	:	3130 GRAND CONCOURSE
Second Line	:	SUITE B8
City	:	BRONX
State	:	NY
Zip	:	10458
Country	:	US
Telephone Number	:	718-365-5662
Fax Number	:	718-933-8208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	02/03/2025

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