Provider Demographics
NPI:1386731479
Name:HARMON, GREGORY K (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:K
Last Name:HARMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 64TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6635
Mailing Address - Country:US
Mailing Address - Phone:212-888-4100
Mailing Address - Fax:212-888-4111
Practice Address - Street 1:205 E 64TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6635
Practice Address - Country:US
Practice Address - Phone:212-888-4100
Practice Address - Fax:212-888-4111
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155183207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01144641Medicaid
NY01144641Medicaid
NY91D741Medicare PIN