Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 277042 | MA |
N | 111NI0900X | Internist | 277042 | MA |
Y | 207RA0401X | Internist - Addiction Medicine | 277042 | MA |
NPI | 1497239677 |
---|---|
Provider Name | Dr. Miriam Tova Henning Harris |
First Address | Boston, MA 02118-2605 |
Second Address | Boston, MA 02118-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2018 |
Last Update Date | 04/03/2019 |