Provider Demographics
NPI:1821026006
Name:HARRIS, ALAN I (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:I
Last Name:HARRIS
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 1:25 CEDARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-1416
Mailing Address - Country:US
Mailing Address - Phone:516-692-4067
Mailing Address - Fax:516-692-4067
Practice Address - Street 1:25 CEDARFIELD RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-1416
Practice Address - Country:US
Practice Address - Phone:516-692-4067
Practice Address - Fax:516-692-4067
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116565207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00416106Medicaid
NY116565OtherLICENSE NUMBER
NYC08240Medicare UPIN
NY312001Medicare ID - Type Unspecified