Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 259717 | NY |
Y | 207QS0010X | Family Doctor - Sports Medicine | 259717 | NY |
NPI | 1033287594 |
---|---|
Provider Name | Dr. Mark J Harary |
First Address | East Setauket, NY 11733-4079 |
Second Address | East Setauket, NY 11733-4079 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 24/05/2019 |