Healthcare Provider Details

I. General information

NPI: 1467445254
Provider Name (Legal Business Name): MORTON SAMUEL ADAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WASHINGTON CTR
NEWBURGH NY
12550
US

IV. Provider business mailing address

3 WASHINGTON CTR
NEWBURGH NY
12550
US

V. Phone/Fax

Practice location:
  • Phone: 845-563-8000
  • Fax: 845-220-3199
Mailing address:
  • Phone: 845-220-3122
  • Fax: 845-220-3199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number100401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: