Fredric Alan Harris

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6175 Issued in NY

Practice address

27 W 96TH St
New York, NY 10025-6607

Phone

(732) 272-3046

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Orange Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Toms River, NJ
  • NPI 1780632802
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1700994696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FARMEDGE LN",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077242705",
            "telephone_number": "732-272-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 W 96TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256607",
            "telephone_number": "732-272-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "FREDRIC",
        "middle_name": "ALAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "6175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Harris
• Dory C Harris, LMSW
• Edward Michael Harris, REGISTERED NURSE
• Emily Harris, OTR/L
• Erin Harris, MD
• Fredric David Harris, MD, FACS
• Fredrick Harris, PH.D., DDS
• Gail Barbara Harris, PHD
• George Benjamin Harris V
• Gwen N Harris, MD

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.