MEDICARE: BRIAN E HARRIS M.D.

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	207R00000X	Internal Medicine Physician	25MA04733100	NJ
2	207P00000X	Emergency Medicine Physician	152013	NY
3	207P00000X	Emergency Medicine Physician	47331	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00624286	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013977453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN E HARRIS M.D.

Provider Business Mailing Address
First Line	:	32 PARK HILL TER
Second Line	:
City	:	WEST WINDSOR
State	:	NJ
Zip	:	08550-1917
Country	:	US
Telephone Number	:	732-284-1964
Fax Number	:

Provider Business Practice Location Address
First Line	:	32 PARK HILL TER
Second Line	:
City	:	WEST WINDSOR
State	:	NJ
Zip	:	08550-1917
Country	:	US
Telephone Number	:	732-284-1964
Fax Number	:

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

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	11/03/2016

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Directions to “ BRIAN E HARRIS M.D.” Practice Location

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