Healthcare Provider Details

I. General information

NPI: 1700295052
Provider Name (Legal Business Name): THOMAS E MOREY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 STATE ROUTE 11
CHAMPLAIN NY
12919-4966
US

IV. Provider business mailing address

9 CAREY RD
QUEENSBURY NY
12804-7880
US

V. Phone/Fax

Practice location:
  • Phone: 518-298-2691
  • Fax: 518-298-8241
Mailing address:
  • Phone: 518-761-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number017599
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: