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NPI Code Detail

MEDICARE: MARY ELIZABETH MORRIS LCAT

MEDICARE: MARY ELIZABETH MORRIS LCAT
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
1101200000XDrama Therapist002751NY

General Provider Information

NPI Number : 1346074309
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ELIZABETH MORRIS LCAT
Provider Business Mailing Address
First Line : 119 W 133RD ST # 5A
Second Line :
City : NEW YORK
State : NY
Zip : 10030-3330
Country : US
Telephone Number : 215-668-7041
Fax Number :
Provider Business Practice Location Address
First Line : 1125 FULTON ST STE 2
Second Line :
City : BROOKLYN
State : NY
Zip : 11238-2669
Country : US
Telephone Number : 917-757-6918
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2024
Last Update Date : 08/30/2024

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