Provider Demographics
NPI:1891879367
Name:HARRIS, LAURENCE STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:STANLEY
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1154
Mailing Address - Country:US
Mailing Address - Phone:212-879-4514
Mailing Address - Fax:212-410-0960
Practice Address - Street 1:1095 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1154
Practice Address - Country:US
Practice Address - Phone:212-879-4514
Practice Address - Fax:212-410-0960
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092819207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NS3609OtherOXFORD PROVIDER NUMBER
504231OtherEMPIRE B/S PROVIDER NUMBE
NS3609OtherOXFORD PROVIDER NUMBER
504231OtherEMPIRE B/S PROVIDER NUMBE