Provider Demographics
NPI:1922056936
Name:BRAM, HARRIS N (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRIS
Middle Name:N
Last Name:BRAM
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 1:1806 HIGHWAY 35
Mailing Address - Street 2:SUITE 305
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2700
Mailing Address - Country:US
Mailing Address - Phone:732-720-0247
Mailing Address - Fax:732-508-9100
Practice Address - Street 1:1806 HIGHWAY 35
Practice Address - Street 2:SUITE 305
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2700
Practice Address - Country:US
Practice Address - Phone:732-720-0247
Practice Address - Fax:732-508-9100
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA57334174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF51460Medicare UPIN
NJBR733367Medicare PIN