Healthcare Provider Details

I. General information

NPI: 1891227104
Provider Name (Legal Business Name): MORGAN PINES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 07/17/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 EASTON AVE MEDICAL OFFICE BUILDING 2ND FLOOR
NEW BRUNSWICK NJ
08901
US

IV. Provider business mailing address

4 CUMBERLAND CT
SOMERSET NJ
08873-1456
US

V. Phone/Fax

Practice location:
  • Phone: 732-745-6674
  • Fax: 732-418-9708
Mailing address:
  • Phone: 551-486-7185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number303504
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number25MA11823800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: