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General NPI Number Information
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NPI Number | 1669467510
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Entity Type | Individual
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Provider Name | ROBERT D. HARRIS R.PH., BCPP
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Gender | Male
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 555 E MARKET ST
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City | ELMIRA
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State | NY
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Zip | 14901-3223
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Country | US
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Telephone | 607-727-1501
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Fax |
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Provider Business Mailing Address
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Address Line | 101 GROVE RD
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City | ITHACA
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State | NY
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Zip | 14850-9532
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Country | US
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Telephone | 607-277-0198
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | 17230
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | 040355-1
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License Number State | NY
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