MEDICARE: LOUIS J MORLEDGE MD, PLLC

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	207R00000X	Internal Medicine Physician	191289	NY

General Provider Information

NPI Number	:	1235102070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUIS J MORLEDGE MD, PLLC

Provider Business Mailing Address
First Line	:	150 E 58TH ST
Second Line	:	18TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10155-0002
Country	:	US
Telephone Number	:	212-583-2830
Fax Number	:	212-583-0444

Provider Business Practice Location Address
First Line	:	150 E 58TH ST
Second Line	:	18TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10155-0002
Country	:	US
Telephone Number	:	212-583-2830
Fax Number	:	212-583-0444

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LOUIS J MORLEDGE JR.
Credential	:	M.D.
Telephone Number	:	212-583-2830

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	11/24/2009

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