Individual
MS. ALETHEA LAVITA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPLUS30
Contact information
Practice address
97 77 QUEENS BLVD., PENTHOUSE, REGO PARK, NY 11374-3300
(718) 830-9274
Mailing address
13918 109TH RD, JAMAICA, NY 11435-5501
(718) 908-6134
(718) 297-1983
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
252Y00000X
TEACHER
NY
Enumeration date
06/15/2012
Last updated
06/15/2012
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