Healthcare Provider Details

I. General information

NPI: 1447194907
Provider Name (Legal Business Name): JOVON C. MORGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 BEDFORD AVE FL 2
BROOKLYN NY
11216-4117
US

IV. Provider business mailing address

1530 BEDFORD AVE FL 2
BROOKLYN NY
11216-4117
US

V. Phone/Fax

Practice location:
  • Phone: 347-404-6508
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number357236
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: