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1518954262

NPI Code Detail

MEDICARE: DR. PHILIP HARRIS MD

MEDICARE: DR. PHILIP HARRIS MD

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	208100000X	Physical Medicine & Rehabilitation Physician	171448	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	06575G	OTHER		GHS

General Provider Information

NPI Number	:	1518954262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP HARRIS MD

Provider Business Mailing Address
First Line	:	274 KELL AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-4114
Country	:	US
Telephone Number	:	718-761-5356
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BROOKDALE PLZ
Second Line	:	ROOM 344 CHC
City	:	BROOKLYN
State	:	NY
Zip	:	11212-3139
Country	:	US
Telephone Number	:	718-240-5126
Fax Number	:	718-240-6550

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

Provider Enumeration Date	:	09/28/2005
Last Update Date	:	02/06/2014

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Directions to “ DR. PHILIP HARRIS MD” Practice Location

Language	Start Address	Practice Location

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