Healthcare Provider Details

I. General information

NPI: 1316798655
Provider Name (Legal Business Name): ANTHONY MORGERA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WAKE ROBIN RD
LINCOLN RI
02865-4295
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 401-333-1747
  • Fax: 401-334-1769
Mailing address:
  • Phone: 951-335-9825
  • Fax: 812-590-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00811-G
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: