Healthcare Provider Details

I. General information

NPI: 1053383455
Provider Name (Legal Business Name): DEBRA HARMADY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 HIGHWAY 35 UNIT # 6
MIDDLETOWN NJ
07748-2040
US

IV. Provider business mailing address

1275 HIGHWAY 35 UNIT # 6
MIDDLETOWN NJ
07748-2040
US

V. Phone/Fax

Practice location:
  • Phone: 732-957-9200
  • Fax: 732-957-9203
Mailing address:
  • Phone: 732-957-9200
  • Fax: 732-957-9203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA070431
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: