Healthcare Provider Details

I. General information

NPI: 1609815133
Provider Name (Legal Business Name): DONN B HARNICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 PARK AVE
NEW YORK NY
10016-5341
US

IV. Provider business mailing address

4 PARK AVE
NEW YORK NY
10016-5341
US

V. Phone/Fax

Practice location:
  • Phone: 212-249-1036
  • Fax:
Mailing address:
  • Phone: 212-249-1036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number51085
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: