Provider Demographics
NPI:1215969985
Name:MORRIS, JAMES RANDALL (MD PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RANDALL
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:170 CLAPBOARD RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-3351
Mailing Address - Country:US
Mailing Address - Phone:203-253-2644
Mailing Address - Fax:914-253-8099
Practice Address - Street 1:5 PERRYRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4608
Practice Address - Country:US
Practice Address - Phone:203-253-2644
Practice Address - Fax:914-253-8099
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1879922084N0400X
CT0352152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT130000647Medicare PIN
CT130000507Medicare ID - Type UnspecifiedCONNECTICUT MEDICARE
G19471Medicare UPIN
CTC03425Medicare PIN
NY395022Medicare ID - Type UnspecifiedMEDICARE