Healthcare Provider Details

I. General information

NPI: 1255075701
Provider Name (Legal Business Name): MORGAN BAGINGITO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 MDG BUILDING 777 SONGTAN BLVD UNIT 2060
APO AP
96278
US

IV. Provider business mailing address

51 MDG BUILDING 777 SONGTAN BLVD UNIT 2060
APO AP
96278
US

V. Phone/Fax

Practice location:
  • Phone: 315-784-2500
  • Fax:
Mailing address:
  • Phone: 315-784-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36113
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: