Provider Demographics
NPI:1588070403
Name:HARBOR VIEW MEDICAL SERVICES PC
Entity type:Organization
Organization Name:HARBOR VIEW MEDICAL SERVICES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-473-1320
Mailing Address - Street 1:75 N COUNTRY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 OAKLAND AVE STE 203
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2130
Practice Address - Country:US
Practice Address - Phone:631-686-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARBOR VIEW MEDICAL SERVICES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-11
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty