Provider Demographics
NPI:1912482746
Name:HARRIS, RAY STANLEY III (RN)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:STANLEY
Last Name:HARRIS
Suffix:III
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2078 2ND AVE APT 7A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4169
Mailing Address - Country:US
Mailing Address - Phone:347-612-5084
Mailing Address - Fax:
Practice Address - Street 1:2078 2ND AVE APT 7A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4169
Practice Address - Country:US
Practice Address - Phone:347-612-5084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7163291163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse