Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | MD025875E | PA |
NPI | 1619081726 |
---|---|
Provider Name | Dr. Bernard Amiel Harris |
First Address | Yeadon, PA 19050-2823 |
Second Address | Darby, PA 19023-1230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 07/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01-0935702 | (05) | PA |