Provider Demographics
NPI:1285464156
Name:MORGAN, MICHELLE R (CRPA-P)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:R
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CRPA-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1008
Mailing Address - Country:US
Mailing Address - Phone:716-821-0391
Mailing Address - Fax:
Practice Address - Street 1:920 HARLEM RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14224-1008
Practice Address - Country:US
Practice Address - Phone:716-821-0391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty