Provider Demographics
NPI:1154436913
Name:HARRIS, STANLEY SETH (DC)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:SETH
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 FAR HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2800
Mailing Address - Country:US
Mailing Address - Phone:203-272-5418
Mailing Address - Fax:
Practice Address - Street 1:826 E CENTER ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-5038
Practice Address - Country:US
Practice Address - Phone:203-265-2171
Practice Address - Fax:203-284-3383
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT709761OtherCONNECTICARE
CT050000332CT01OtherANTHEM BLUE CROSS
CT4404322OtherUNITED HEALTH CARE
CT350000217Medicare ID - Type Unspecified