Provider Demographics
NPI:1316772478
Name:MORILLO, JUSTIANNY
Entity type:Individual
Prefix:
First Name:JUSTIANNY
Middle Name:
Last Name:MORILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 PELHAMDALE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-1416
Mailing Address - Country:US
Mailing Address - Phone:646-915-2093
Mailing Address - Fax:
Practice Address - Street 1:754 PELHAMDALE AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-1416
Practice Address - Country:US
Practice Address - Phone:646-915-2093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator