MEDICARE: LEE JAMES 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	204R00000X	Electrodiagnostic Medicine Physician	MD043442E	PA
2	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	MD043442E	PA
3	2084N0400X	Neurology Physician	MD043422-E	PA

General Provider Information

NPI Number	:	1558463232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE JAMES HARRIS M.D.

Provider Business Mailing Address
First Line	:	1151 OLD YORK RD STE 200
Second Line	:
City	:	ABINGTON
State	:	PA
Zip	:	19001-3816
Country	:	US
Telephone Number	:	215-957-9250
Fax Number	:	215-957-9254

Provider Business Practice Location Address
First Line	:	2325 MARYLAND RD
Second Line	:	SUITE 120
City	:	WILLOW GROVE
State	:	PA
Zip	:	19090-1749
Country	:	US
Telephone Number	:	215-957-9250
Fax Number	:	215-957-9254

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

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	01/24/2021

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