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Individual

DR. HARRISON PHILLIP BANNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
620 NORTH BROAD STREET, WOODBURY, NJ 08096-1795
(856) 853-5554
(856) 853-5650
Mailing address
620 NORTH BROAD STREET, WOODBURY, NJ 08096-1795
(856) 853-5554
(856) 853-5650

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MB11890500
NJ
207W00000X
Ophthalmology Physician
71130
CT
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
25MB11890500
NJ

Other

Enumeration date
04/11/2018
Last updated
09/20/2023
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