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General NPI Number Information
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NPI Number | 1194917443
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Entity Type | Organization
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Legal Business Name | DR ANDREW M HARARAH DO PC MEDICAL C
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 357 BROADWAY
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City | AMITYVILLE
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State | NY
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Zip | 11701-2748
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Country | US
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Telephone | 631-789-7900
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Fax | 631-608-8492
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Provider Business Mailing Address
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Address Line | 357 BROADWAY
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City | AMITYVILLE
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State | NY
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Zip | 11701-2748
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Country | US
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Telephone | 631-789-7900
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JOHN PFEIL
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Credential | MA
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Telephone | 631-789-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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