Individual
KENYATTA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
560 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-3000
Mailing address
130 GEORGE RUSSELL WAY, CLIFTON, NJ 07013-2683
(347) 820-3722
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
6251891
NY
363L00000X
Nurse Practitioner
Primary
431394
NY
Other
Enumeration date
10/04/2010
Last updated
01/30/2019
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