Provider Demographics
NPI:1346089398
Name:MOREY, ELIZABETH GRACE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GRACE
Last Name:MOREY
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 1:3911 STETSON CIR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-1027
Mailing Address - Country:US
Mailing Address - Phone:315-416-0166
Mailing Address - Fax:
Practice Address - Street 1:3911 STETSON CIR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-1027
Practice Address - Country:US
Practice Address - Phone:315-416-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant