Healthcare Provider Details

I. General information

NPI: 1255500617
Provider Name (Legal Business Name): ERIC J MORLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 11/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 NICHOLLS RD
STONY BROOK NY
11794-0001
US

IV. Provider business mailing address

101 NICHOLLS RD
STONY BROOK NY
11794-0001
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-2478
  • Fax:
Mailing address:
  • Phone: 631-444-2478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number247008
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: