Provider Demographics
NPI:1427604743
Name:HARRIS, JEFFREY ALAN JR
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALAN
Last Name:HARRIS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-4501
Mailing Address - Country:US
Mailing Address - Phone:914-565-5750
Mailing Address - Fax:
Practice Address - Street 1:60 PALMERS HILL RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2113
Practice Address - Country:US
Practice Address - Phone:203-324-3167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health