MEDICARE: JOSEPH G. MORRA, O.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TUV4595	NY

General Provider Information

NPI Number	:	1871800334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH G. MORRA, O.D., P.C.

Provider Business Mailing Address
First Line	:	2988 NABIL ST
Second Line	:
City	:	BALDWINSVILLE
State	:	NY
Zip	:	13027-9504
Country	:	US
Telephone Number	:	315-450-8686
Fax Number	:

Provider Business Practice Location Address
First Line	:	5349 W TAFT RD
Second Line	:
City	:	NORTH SYRACUSE
State	:	NY
Zip	:	13212-2747
Country	:	US
Telephone Number	:	315-458-8010
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH GERARD MORRA
Credential	:	O.D.
Telephone Number	:	315-450-8686

Provider Enumeration Date	:	09/04/2010
Last Update Date	:	09/04/2010

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