Provider Demographics
NPI:1992176978
Name:MORLEY, PATRICIA (RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MORLEY
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 SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:POESTENKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12140-1809
Mailing Address - Country:US
Mailing Address - Phone:518-674-7127
Mailing Address - Fax:
Practice Address - Street 1:1 SCHOOL RD
Practice Address - Street 2:
Practice Address - City:POESTENKILL
Practice Address - State:NY
Practice Address - Zip Code:12140-1809
Practice Address - Country:US
Practice Address - Phone:518-674-7127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY593432251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01379024Medicaid