Provider Demographics
NPI:1548240096
Name:PRYWES, HARRY CHARLES (DPM)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:CHARLES
Last Name:PRYWES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 VILLAGE SQ. PMB 227
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-2305
Mailing Address - Country:US
Mailing Address - Phone:914-723-0125
Mailing Address - Fax:914-723-8904
Practice Address - Street 1:108 VILLAGE SQ. PMB 227
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-2305
Practice Address - Country:US
Practice Address - Phone:914-723-0125
Practice Address - Fax:914-723-8904
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN2870213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00413245Medicaid
NY00413245Medicaid
NYP31532Medicare PIN