Professional Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0704871 Issued in NY

Legal business name

PROFESSIONAL CORPORATION

Practice address

2 Academy LN
Bellport, NY 11713-2702

Phone

(631) 286-3572

NPI assigned

Jun 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Arthur Harder, MD

Title

Individual Practitioner

Phone

(631) 286-3572

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465948800000",
    "number": "1508216185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ACADEMY LN",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132702",
            "telephone_number": "631-286-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ACADEMY LN",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132702",
            "telephone_number": "631-286-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "INDIVIDUAL PRACTITIONER",
        "authorized_official_telephone_number": "631-286-3572",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "0704871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PRACTITIONER",
            "identifier": "0704871",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Pentecost
• Sarah Perrino
• Yolette Pierre
• Kim Denise Potter, LPN
• Courtney Prada, OTR/L
• QK Healthcare, Inc.
• Quality King Distributors, Inc.
• Emily Paige Reich, RDN
• Michael Rene, LMSW
• Mary Restaino, RN

• Primary Care Clinic/Center in Bellport, NY
• Providers in Bellport, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.