Healthcare Provider Details

I. General information

NPI: 1811460868
Provider Name (Legal Business Name): RYAN STEVEN MORASSE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST
BRONX NY
10451-5504
US

IV. Provider business mailing address

279 CUMBERLAND ST APT 1
BROOKLYN NY
11238-6419
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5000
  • Fax:
Mailing address:
  • Phone: 949-500-8108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD30102
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number39109
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01099092A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: