Provider Demographics
NPI:1306105846
Name:MORCOS, SALLY (PSYD)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:
Last Name:MORCOS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 N 3RD AVE
Mailing Address - Street 2:SUITE 203E
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2429
Mailing Address - Country:US
Mailing Address - Phone:732-672-6564
Mailing Address - Fax:
Practice Address - Street 1:24 N 3RD AVE
Practice Address - Street 2:SUITE 203E
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2429
Practice Address - Country:US
Practice Address - Phone:732-735-1561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019387103T00000X
NJ5012103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist