Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Harris Psychiatric Services, PLLC before sending sensitive documents. FaxFlow is not affiliated with this organization.
Harris Psychiatric Services, PLLC fax number
(631) 265-3042
Psychiatry
Used for: PHI release and medical records requests
Fax destination details
- Department
- Psychiatry
- Purpose
- PHI release and medical records requests
- Form
- Standard Authorization of Use and Disclosure of Protected Health Information — Standard Authorization of Use and Disclosure of Protected Health Information
- Address
- 222 Middle Country Road, Suite 310, Smithtown, NY 11787
- Voice phone
- 631-265-1622
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Complete patient name, dates, recipient, description of information to be disclosed, and signature/date; then fax the completed form to 631-265-3042.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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