Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 25MA06571000 | NJ |
NPI | 1386733186 |
---|---|
Provider Name | Lawrence Evan Harrison |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 23/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7346301 | (05) | NJ |
G33432 | (02) | NJ |