Provider Demographics
NPI:1295874154
Name:HARRIS, PAULA SUSAN (DC)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:SUSAN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 W BROADWAY
Mailing Address - Street 2:SUITE #2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2400
Mailing Address - Country:US
Mailing Address - Phone:212-226-6346
Mailing Address - Fax:212-226-6598
Practice Address - Street 1:249 W BROADWAY
Practice Address - Street 2:SUITE #2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2400
Practice Address - Country:US
Practice Address - Phone:212-226-6346
Practice Address - Fax:212-226-6598
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor