MEDICARE: DR. JOSEPH GERARD MORRA O.D.

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	152W00000X	Optometrist	VUT004595	NY

General Provider Information

NPI Number	:	1760484091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH GERARD MORRA O.D.

Provider Business Mailing Address
First Line	:	2988 NABIL ST
Second Line	:
City	:	BALDWINSVILLE
State	:	NY
Zip	:	13027-9504
Country	:	US
Telephone Number	:	315-450-8686
Fax Number	:

Provider Business Practice Location Address
First Line	:	5349 W TAFT RD
Second Line	:
City	:	NORTH SYRACUSE
State	:	NY
Zip	:	13212-2747
Country	:	US
Telephone Number	:	315-458-8010
Fax Number	:	315-458-8011

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/08/2007

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