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NPI Code Detail

MEDICARE: DR. ANDREW M HARARAH D.O.

MEDICARE: DR. ANDREW M HARARAH D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician213353NY

General Provider Information

NPI Number : 1104920255
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW M HARARAH D.O.
Provider Business Mailing Address
First Line : 357 BROADWAY
Second Line :
City : AMITYVILLE
State : NY
Zip : 11701-2748
Country : US
Telephone Number : 631-789-7900
Fax Number : 631-608-8492
Provider Business Practice Location Address
First Line : 357 BROADWAY
Second Line :
City : AMITYVILLE
State : NY
Zip : 11701-2748
Country : US
Telephone Number : 631-789-7900
Fax Number : 631-608-8492
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2006
Last Update Date : 02/14/2023

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