Healthcare Provider Details

I. General information

NPI: 1811990997
Provider Name (Legal Business Name): MARTIN MORELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 MIDDLE SETTLEMENT RD SUITE 106
NEW HARTFORD NY
13413-5319
US

IV. Provider business mailing address

4401 MIDDLE SETTLEMENT RD SUITE 106
NEW HARTFORD NY
13413-5319
US

V. Phone/Fax

Practice location:
  • Phone: 315-724-5333
  • Fax: 315-724-5255
Mailing address:
  • Phone: 315-724-5333
  • Fax: 315-724-5255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number196401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: