Healthcare Provider Details

I. General information

NPI: 1497767263
Provider Name (Legal Business Name): MORRISTOWN NEUROLOGICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 05/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 MADISON AVE SUITE 411
MORRISTOWN NJ
07960-6092
US

IV. Provider business mailing address

95 MADISON AVE SUITE 411
MORRISTOWN NJ
07960-6092
US

V. Phone/Fax

Practice location:
  • Phone: 973-455-7444
  • Fax: 973-455-7447
Mailing address:
  • Phone: 973-455-7444
  • Fax: 973-455-7447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number25MB08082800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MB08082800
License Number StateNJ

VIII. Authorized Official

Name: DR. BRIAN JOHN MORSE
Title or Position: PRESIDENT
Credential: DO
Phone: 973-455-7444