Provider Demographics
NPI:1841574464
Name:HARRIS, MONIKA
Entity Type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 W HENLEY ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-3541
Mailing Address - Country:US
Mailing Address - Phone:716-375-8945
Mailing Address - Fax:716-375-8950
Practice Address - Street 1:411 W HENLEY ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-3541
Practice Address - Country:US
Practice Address - Phone:716-375-8945
Practice Address - Fax:716-375-8950
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY379941-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool