Provider Demographics
NPI:1427457340
Name:MORTON, JOANN (LAC, LMT)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:MORTON
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 56TH ST
Mailing Address - Street 2:APT 1008
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3583
Mailing Address - Country:US
Mailing Address - Phone:646-250-7015
Mailing Address - Fax:
Practice Address - Street 1:500 W 56TH ST
Practice Address - Street 2:APT 1008
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3583
Practice Address - Country:US
Practice Address - Phone:646-250-7015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005328171100000X
NY022719225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist