Harris, Juan-Diego

Harris, Juan-Diego is an sole proprietor health care provider with primary practice located at 3 Lyon Pl , Ogdensburg NY 13669-2590. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Harris, Juan-Diego can be contacted via phone (315) 394-7542.

Contact Information

Primary practice address
3 Lyon Pl Ogdensburg NY 13669-2590
Phone: (315) 394-7542
Fax: (315) 394-0015
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X X001531-1 New York
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 001531 New York

Profile Details

NPI number 1306827654
LBN Legal business name Harris, Juan-Diego
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 11th, 2005
Last updated Dec 12th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306827654 NPPES
New York Other RB6019 PTAN
New York MEDICAID 02375226 PTAN

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