Provider Demographics
NPI:1104236678
Name:HARNETT, GREGORY E
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:E
Last Name:HARNETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 OLD WEST POINT RD E
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10524-3834
Mailing Address - Country:US
Mailing Address - Phone:914-382-6122
Mailing Address - Fax:
Practice Address - Street 1:151 OLD WEST POINT RD E
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:NY
Practice Address - Zip Code:10524-3834
Practice Address - Country:US
Practice Address - Phone:914-382-6122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2015-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019352-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist