Provider Demographics
NPI:1760791750
Name:HARRIS, DENISE (RN, FNP)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:PILGRIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:555 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-1018
Mailing Address - Country:US
Mailing Address - Phone:718-455-4047
Mailing Address - Fax:
Practice Address - Street 1:121 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5425
Practice Address - Country:US
Practice Address - Phone:718-250-8000
Practice Address - Fax:718-250-6961
Is Sole Proprietor?:No
Enumeration Date:2010-09-25
Last Update Date:2010-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF-335105-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily