MEDICARE: DR. ANITA BEATRICE HARAVON PH.D., CCC-A

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
1	231H00000X	Audiologist	001965-1	NY
2	231H00000X	Audiologist	41YA00066500	NJ
3	237600000X	Audiologist-Hearing Aid Fitter	14000018441	NY

General Provider Information

NPI Number	:	1366444044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANITA BEATRICE HARAVON PH.D., CCC-A

Provider Business Mailing Address
First Line	:	308 W 82ND ST
Second Line	:	#12B
City	:	NEW YORK
State	:	NY
Zip	:	10024-5344
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1175 PARK AVE
Second Line	:	SUITE 1A
City	:	NEW YORK
State	:	NY
Zip	:	10128-1211
Country	:	US
Telephone Number	:	212-996-2995
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	09/11/2025

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