Healthcare Provider Details

I. General information

NPI: 1184678476
Provider Name (Legal Business Name): JAY MORROS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 LOMBARD ST
PHILADELPHIA PA
19146-8400
US

IV. Provider business mailing address

1280 COX RD
RYDAL PA
19046-1207
US

V. Phone/Fax

Practice location:
  • Phone: 215-893-2353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberMD046772L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: