Provider Demographics
NPI:1124029269
Name:HARNEY, STEPHEN JAMES (OD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JAMES
Last Name:HARNEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 JAMBARD RD
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NH
Mailing Address - Zip Code:03049-6589
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:850 CHELMSFORD ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-5149
Practice Address - Country:US
Practice Address - Phone:978-452-0127
Practice Address - Fax:978-452-1749
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2881152W00000X
NH0421152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0006470OtherNEIGHBORHOOD HEALTH PLAN
NH21772090797Medicaid
NH7977OtherANTHEM BC/BS
MA982567OtherNETWORK HEALTH
MA32897OtherJOHNHANCOCK/CHILDERN
MA759071OtherTUFTS TOTAL HEALTH PLAN
MAW16053OtherBC/BS INDEMINITY PLAN
MA3201287OtherAETNA US HEALTHCARE
MA24052OtherFALLON HEALTH PLANS
MA444558OtherHMOBLUE
MA7745879OtherCIGNA HEALTHCARE
MA151438OtherHARVARD PILGRIM HC
MA158296XXOtherPHCS
MA151438OtherHARVARD PILGRIM HC
MA24052OtherFALLON HEALTH PLANS
MA1306770002Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPTMEN
MA444558Medicare ID - Type Unspecified
NH7977OtherANTHEM BC/BS