Basic Information
| Provider Information | |||||||||
| NPI: | 1912915125 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 GALLOPING HILL RD STE 305 | ||||||||
| Address2: | |||||||||
| City: | UNION | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070837991 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9084588333 | ||||||||
| FaxNumber: | 9084588339 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 GALLOPING HILL RD STE 305 | ||||||||
| Address2: | |||||||||
| City: | UNION | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070837991 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9084588333 | ||||||||
| FaxNumber: | 9084588339 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 08/01/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 46576 | NJ | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207WX0107X | 25MA04657600 | NJ | Y |
No ID Information.