Provider Demographics
NPI:1023680410
Name:HARRIS, ELISHA REED (BA)
Entity type:Individual
Prefix:
First Name:ELISHA
Middle Name:REED
Last Name:HARRIS
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 SPEEDWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2100
Mailing Address - Country:US
Mailing Address - Phone:973-623-0600
Mailing Address - Fax:
Practice Address - Street 1:415 SPEEDWELL AVE
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2100
Practice Address - Country:US
Practice Address - Phone:973-623-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator