Healthcare Provider Details

I. General information

NPI: 1346972148
Provider Name (Legal Business Name): MORGAN SIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 VESTAL PKWY E FL 2
VESTAL NY
13850-3556
US

IV. Provider business mailing address

4433 VESTAL PKWY E FL 2
VESTAL NY
13850-3556
US

V. Phone/Fax

Practice location:
  • Phone: 607-772-8772
  • Fax:
Mailing address:
  • Phone: 607-772-8772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.004199
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: