Healthcare Provider Details

I. General information

NPI: 1821069618
Provider Name (Legal Business Name): DOROTHY A MORGAN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 06/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CLARA DR
EAST QUOGUE NY
11942
US

IV. Provider business mailing address

137 RIVERHEAD RD
WESTHAMPTON BEACH NY
11978-1213
US

V. Phone/Fax

Practice location:
  • Phone: 631-831-4030
  • Fax:
Mailing address:
  • Phone: 631-831-4030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400843
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: