Provider Demographics
NPI:1699763730
Name:MORGAN, ROBERT L (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:MORGAN
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 1:55 N GILBERT ST
Mailing Address - Street 2:SUITE 2101
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4904
Mailing Address - Country:US
Mailing Address - Phone:732-842-6677
Mailing Address - Fax:732-530-2946
Practice Address - Street 1:55 N GILBERT ST
Practice Address - Street 2:SUITE 2101
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4904
Practice Address - Country:US
Practice Address - Phone:732-842-6677
Practice Address - Fax:732-530-2946
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04082500208M00000X
NJMA40825208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2003405Medicaid
NJ2003405Medicaid