Healthcare Provider Details

I. General information

NPI: 1154043685
Provider Name (Legal Business Name): STACEY ALANNA MORRIS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E 56TH ST RM 610
NEW YORK NY
10022-3667
US

IV. Provider business mailing address

237 DUFFIELD ST APT 21E
BROOKLYN NY
11201-5185
US

V. Phone/Fax

Practice location:
  • Phone: 212-826-2322
  • Fax:
Mailing address:
  • Phone: 917-678-3750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number063573-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: