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General NPI Number Information
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NPI Number | 1902375835
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Entity Type | Individual
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Provider Name | LAURA ELIZABETH MORRIS MS, PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 5520 PARK AVE
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City | TRUMBULL
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State | CT
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Zip | 06611-3463
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Country | US
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Telephone | 203-377-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 285 MARSHALLVILLE RD
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City | WOODBINE
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State | NJ
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Zip | 08270-9722
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Country | US
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Telephone | 609-335-8702
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 4338
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License Number State | CT
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