Provider Demographics
NPI:1730402819
Name:FOX, HARVEY J (R PH)
Entity type:Individual
Prefix:
First Name:HARVEY
Middle Name:J
Last Name:FOX
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 KRISTIN LN
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-1235
Mailing Address - Country:US
Mailing Address - Phone:631-979-6399
Mailing Address - Fax:
Practice Address - Street 1:106 BROADWAY
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740-1310
Practice Address - Country:US
Practice Address - Phone:631-754-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist