Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 0000536 | VT |
Y | 111NN0400X | Neurology | X004113-2 | NY |
N | 225100000X | Physical Therapist | 040.0059361 | VT |
NPI | 1871528000 |
---|---|
Provider Name | Dr. Dean J. Harrison |
First Address | Granville, NY 12832-2606 |
Second Address | Granville, NY 12832-2606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 19/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000536 | (02) | VT |
000053601 | (02) | VT |
6003082 | MVP (01) | NY |
808682 | MPN (01) | NY |
CC8232 | (02) | NY |
HARR00069148 | BCBSOF VT (01) | VT |
X5M26 | EMPIRE BCBS (01) | NY |