Provider Demographics
NPI:1356314017
Name:ADDRIZZO-HARRIS, DOREEN (MD)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:
Last Name:ADDRIZZO-HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 2ND AVE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2739
Mailing Address - Country:US
Mailing Address - Phone:212-598-6516
Mailing Address - Fax:212-598-6212
Practice Address - Street 1:305 2ND AVE
Practice Address - Street 2:SUITE 16
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2739
Practice Address - Country:US
Practice Address - Phone:212-598-6516
Practice Address - Fax:212-598-6212
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182771207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY472342Medicare ID - Type Unspecified