Provider Demographics
NPI:1033277124
Name:HARRIS, BARRY (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 MARCHWOOD ROAD
Mailing Address - Street 2:SUITE 1 K
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341
Mailing Address - Country:US
Mailing Address - Phone:610-363-8686
Mailing Address - Fax:610-363-8686
Practice Address - Street 1:47 MARCHWOOD ROAD
Practice Address - Street 2:SUITE 1 K
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341
Practice Address - Country:US
Practice Address - Phone:610-363-8686
Practice Address - Fax:610-363-8686
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002282L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA030669Medicare ID - Type Unspecified