=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164689188
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MORRIS WESTFRIED MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2008
-----------------------------------------------------
Last Update Date | 01/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7508 15TH AVE
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11228-2502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-837-9004
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7508 15TH AVE
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11228-2502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-837-9004
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. MORRIS JACK WESTFRIED
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 718-837-9004
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207N00000X
-----------------------------------------------------
Taxonomy Name | Dermatology Physician
-----------------------------------------------------
License Number | 127374
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------