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General NPI Number Information
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NPI Number | 1568714905
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Entity Type | Individual
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Provider Name | ELIZABETH JOAN MORGAN RD
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Gender | Female
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 1 HOSPITAL DR
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City | MASSENA
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State | NY
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Zip | 13662-1056
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Country | US
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Telephone | 315-769-4255
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Fax |
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Provider Business Mailing Address
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Address Line | 387 MAY RD
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City | POTSDAM
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State | NY
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Zip | 13676-3242
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Country | US
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Telephone | 518-651-5542
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 003510-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 714751
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License Number State | NY
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