Provider Demographics
NPI:1982791323
Name:HARRIS, MARCIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:A
Last Name: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 1:360 E 72ND ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4753
Mailing Address - Country:US
Mailing Address - Phone:212-249-1741
Mailing Address - Fax:212-628-8224
Practice Address - Street 1:360 E 72ND ST STE 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4753
Practice Address - Country:US
Practice Address - Phone:212-249-1741
Practice Address - Fax:212-628-8224
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129996207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC07401Medicare UPIN