Provider Demographics
NPI:1023276458
Name:KESSARIS, HARLAND
Entity type:Individual
Prefix:DR
First Name:HARLAND
Middle Name:
Last Name:KESSARIS
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 1:154 W 127TH ST
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3722
Mailing Address - Country:US
Mailing Address - Phone:212-749-3507
Mailing Address - Fax:212-666-1679
Practice Address - Street 1:154 W 127TH ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-3722
Practice Address - Country:US
Practice Address - Phone:212-749-3507
Practice Address - Fax:212-666-1679
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011287-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist