| Physician Last Name: | Harbor Medical & Diagnostic |
| Physician First Name: | P.C. |
| Physician Middle Name: | |
| Address: | 197-27 Hillside Avenue
Hollis, New York |
| License Number: | 094241 |
| License Type: | |
| Year of Birth: |
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| Effective Date: | 05/15/2007 |
| Action Description for DOH Webpage: | Annulment of certificate of incorporation pursuant to Section 230-a of the New York State Public Health Law and Section 1503(d) of the New York State Business Corporation Law |
| Misconduct Description for DOH Webpage: | Failure to comply with Section 1503 of the New York Business Corporation Law. |
| License Limitations or Conditions for DOH Webpage: | |
| Board Order: |
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