Healthcare Provider Details
I. General information
NPI: 1952064859
Provider Name (Legal Business Name): MEDICAL CARE INNOVATION, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2021
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 NEW YORK TIMES PLZ
FLUSHING NY
11354-1200
US
IV. Provider business mailing address
W227N6103 SUSSEX RD
SUSSEX WI
53089-3969
US
V. Phone/Fax
- Phone: 414-566-8400
- Fax:
- Phone: 414-566-8400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFERSON
HARMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 414-566-8400