Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 018261 | NY |
N | 103TC0700X | Clinical Psychologist | 018261 | NY |
Y | 102L00000X | Psychologist | 018261 | NY |
Y | 103T00000X | Psychologist | 018261 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 018261 | NY |
N | 103TS0200X | School Psychologist | 7398 | NY |
NPI | 1215077706 |
---|---|
Provider Name | Dr. Brian Joseph Harris |
First Address | Northport, NY 11768-0115 |
Second Address | Northport, NY 11768-1214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 25/02/2010 |