MEDICARE: JUDY MORGAN

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	172A00000X	Driver

General Provider Information

NPI Number	:	1871251397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY MORGAN

Provider Business Mailing Address
First Line	:	1231 GILHAM ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-5521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1231 GILHAM ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-5521
Country	:	US
Telephone Number	:	215-520-0223
Fax Number	:

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

Provider Enumeration Date	:	12/01/2021
Last Update Date	:	12/01/2021

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Directions to “ JUDY MORGAN ” Practice Location

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