Healthcare Provider Details

I. General information

NPI: 1518461714
Provider Name (Legal Business Name): ZACHARY MATHIAS HARVANEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 PARK ST
NEW HAVEN CT
06519-1109
US

IV. Provider business mailing address

300 GEORGE ST STE 901
NEW HAVEN CT
06511-6662
US

V. Phone/Fax

Practice location:
  • Phone: 203-215-6887
  • Fax:
Mailing address:
  • Phone: 203-785-2095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number66406
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number66406
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: