Provider Demographics
NPI:1215745237
Name:HARRISON, ERROL SR
Entity type:Individual
Prefix:MR
First Name:ERROL
Middle Name:
Last Name:HARRISON
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3646 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-5907
Mailing Address - Country:US
Mailing Address - Phone:914-635-4523
Mailing Address - Fax:
Practice Address - Street 1:3646 HARPER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-5907
Practice Address - Country:US
Practice Address - Phone:914-635-4523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY624692667343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)