Provider Demographics
NPI:1528802667
Name:HARRINGTON, MARISOL PAGE (MD)
Entity type:Individual
Prefix:
First Name:MARISOL
Middle Name:PAGE
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARISOL
Other - Middle Name:PAGE
Other - Last Name:TRACY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 E LEHIGH AVE BLDG SUITE105
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-1012
Mailing Address - Country:US
Mailing Address - Phone:215-707-8496
Mailing Address - Fax:
Practice Address - Street 1:100 E LEHIGH AVE STE 105
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-1012
Practice Address - Country:US
Practice Address - Phone:215-707-8496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT2326922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry