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.

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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

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.
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Complete patient name, dates, recipient, description of information to be disclosed, and signature/date; then fax the completed form to 631-265-3042.

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