Healthcare Provider Details

I. General information

NPI: 1144218397
Provider Name (Legal Business Name): SAFINAZ L. MORCOS D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 ANDERSON ST
HACKENSACK NJ
07601-4578
US

IV. Provider business mailing address

32 ANDERSON ST
HACKENSACK NJ
07601-4578
US

V. Phone/Fax

Practice location:
  • Phone: 201-457-1010
  • Fax: 201-457-1540
Mailing address:
  • Phone: 201-457-1010
  • Fax: 201-457-1540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number19419
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier6698000
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: