Provider Demographics
NPI:1548254923
Name:MORGAN, AUDREY ISABEL (RN)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:ISABEL
Last Name:MORGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FORBES RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-7130
Mailing Address - Country:US
Mailing Address - Phone:845-536-6991
Mailing Address - Fax:845-290-0678
Practice Address - Street 1:1 FORBES RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-7130
Practice Address - Country:US
Practice Address - Phone:845-536-6991
Practice Address - Fax:845-290-0678
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4673071163W00000X
NJ26NR09713400163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02116498Medicaid