MEDICARE: DR. DAVID E. HARRISON D.O.

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	MB057134	NJ

General Provider Information

NPI Number	:	1689653313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID E. HARRISON D.O.

Provider Business Mailing Address
First Line	:	9031 2ND AVE
Second Line	:
City	:	STONE HARBOR
State	:	NJ
Zip	:	08247-2053
Country	:	US
Telephone Number	:	160-957-6979
Fax Number	:	160-924-9281

Provider Business Practice Location Address
First Line	:	211 S MAIN ST
Second Line	:	SUITE 302 A
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2264
Country	:	US
Telephone Number	:	160-946-5444
Fax Number	:

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	11/26/2012

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