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NPI Code Detail

MEDICARE: MAGGIE HARRIS

MEDICARE: MAGGIE HARRIS
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
1103TC0700XClinical Psychologist025244NY

General Provider Information

NPI Number : 1740904911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAGGIE HARRIS
Provider Business Mailing Address
First Line : 1430 BROADWAY RM 1510
Second Line :
City : NEW YORK
State : NY
Zip : 10018-3368
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1430 BROADWAY RM 1510
Second Line :
City : NEW YORK
State : NY
Zip : 10018-3368
Country : US
Telephone Number : 212-262-2850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2022
Last Update Date : 10/14/2022

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