MEDICARE: DR. GREGORY G. HARRIS MD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	79525	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	HAJ14771	OTHER	MA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J14771	OTHER	MA	PTAN
2	J14771	OTHER	MA	BLUECROSS BLUESHIELD MA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619923877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY G. HARRIS MD, MPH

Provider Business Mailing Address
First Line	:	1770 MASSACHUSETTS AVE # 271
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02140-2808
Country	:	US
Telephone Number	:	617-983-0076
Fax Number	:	877-991-8309

Provider Business Practice Location Address
First Line	:	1415 BEACON ST
Second Line	:	STE 320
City	:	BROOKLINE
State	:	MA
Zip	:	02446-4812
Country	:	US
Telephone Number	:	617-983-0076
Fax Number	:	877-991-8309

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	12/31/2020

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