Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 38MC005004 | NJ |
NPI | 1306976329 |
---|---|
Provider Name | Dr. John Victor Harrington |
First Address | East Stroudsburg, PA 18301-8677 |
Second Address | Blairstown, NJ 07825-2115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 08/07/2007 |