Provider Demographics
NPI:1427815877
Name:HARRIS, ERIN (LO)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 COMMERCIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-2537
Mailing Address - Country:US
Mailing Address - Phone:203-483-1876
Mailing Address - Fax:203-488-3560
Practice Address - Street 1:120 COMMERCIAL PKWY
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-2537
Practice Address - Country:US
Practice Address - Phone:203-483-1876
Practice Address - Fax:203-488-3560
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1770156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician