Provider Demographics
NPI:1902402522
Name:ADLER, HARRIS
Entity Type:Individual
Prefix:
First Name:HARRIS
Middle Name:
Last Name:ADLER
Suffix:
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 1:1621 CROWN POINT LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2757
Mailing Address - Country:US
Mailing Address - Phone:215-498-6838
Mailing Address - Fax:
Practice Address - Street 1:137 ROUTE 70
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2378
Practice Address - Country:US
Practice Address - Phone:609-654-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02601500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist