Haven Medical Services, PLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

115112 Issued in NY

Legal business name

HAVEN MEDICAL SERVICES, PLC

Practice address

1350 Route 112
Port Jefferson Station, NY 11776-3078

Phone

(631) 473-3304

Fax

(631) 474-1692

NPI assigned

Apr 1, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Corazon M Go, M.D.

Title

Owner

Phone

(631) 473-3304

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1235301185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763078",
            "telephone_number": "631-473-3304",
            "fax_number": "631-474-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763078",
            "telephone_number": "631-473-3304",
            "fax_number": "631-474-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN MEDICAL SERVICES, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "GO",
        "authorized_official_first_name": "CORAZON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-473-3304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "115112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00211463",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith Webb Harris II, DO
• Kelly Ann Harsch, NP
• Gerald David Hartman, M.D.
• Zahra M Hasan, PHARMD
• Kayla Haug, NP
• Healing Points Acupuncture PC
• Nancy Heeman
• Leah T Hehn
• Thomas J Heinisch, PA-C
• Robert Charles Hendler

• Internal Medicine Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.