MEDICARE: MS. MORGAN LEE DORIA M.A. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	017619-1	NY

General Provider Information

NPI Number	:	1164733549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MORGAN LEE DORIA M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	300 E 40TH ST
Second Line	:	22F
City	:	NEW YORK
State	:	NY
Zip	:	10016-2188
Country	:	US
Telephone Number	:	732-616-4678
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E 40TH ST
Second Line	:	APT. 22F
City	:	NEW YORK
State	:	NY
Zip	:	10016-2188
Country	:	US
Telephone Number	:	732-616-4678
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	02/18/2013

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