Healthcare Provider Details

I. General information

NPI: 1154737567
Provider Name (Legal Business Name): ELIZABETH M. MORRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE FL 2
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

550 1ST AVE FL 2
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5230
  • Fax:
Mailing address:
  • Phone: 212-263-5230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number26356
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number305443
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: