Provider Demographics
NPI:1528149507
Name:MORRISON, JEFFREY ALLAN (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALLAN
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 5TH AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1009
Mailing Address - Country:US
Mailing Address - Phone:212-989-9828
Mailing Address - Fax:212-989-9827
Practice Address - Street 1:103 5TH AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1009
Practice Address - Country:US
Practice Address - Phone:212-989-9828
Practice Address - Fax:212-989-9827
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG91457Medicare UPIN