MEDICARE: DR. HAROLD S. HEFTER M.D.

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	207NS0135X	Procedural Dermatology Physician	151140	NY

General Provider Information

NPI Number	:	1952445389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD S. HEFTER M.D.

Provider Business Mailing Address
First Line	:	135 ROCKAWAY TPKE
Second Line	:	SUITE 100
City	:	LAWRENCE
State	:	NY
Zip	:	11559-1023
Country	:	US
Telephone Number	:	516-371-1600
Fax Number	:	516-371-1681

Provider Business Practice Location Address
First Line	:	135 ROCKAWAY TPKE
Second Line	:	SUITE 100
City	:	LAWRENCE
State	:	NY
Zip	:	11559-1023
Country	:	US
Telephone Number	:	516-371-1600
Fax Number	:	516-371-1681

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

Provider Enumeration Date	:	02/18/2007
Last Update Date	:	07/08/2007

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