Provider Demographics
NPI:1053777128
Name:HARRIS, MATTHEW (PSYD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 STEBBINS AVE
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-3828
Mailing Address - Country:US
Mailing Address - Phone:914-572-1637
Mailing Address - Fax:
Practice Address - Street 1:351 MANVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2152
Practice Address - Country:US
Practice Address - Phone:914-572-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021216103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist