Healthcare Provider Details

I. General information

NPI: 1710391560
Provider Name (Legal Business Name): JONATHAN EDWARD HARVEY PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 COURT ST STE 409
BROOKLYN NY
11242-1134
US

IV. Provider business mailing address

478 E 9TH ST APT 3F
BROOKLYN NY
11218-5250
US

V. Phone/Fax

Practice location:
  • Phone: 908-671-1386
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number027496
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number027496
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number027496
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number027496
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: