Provider Demographics
NPI:1992255285
Name:MORRISON, ANDY
Entity type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 TRUMBULL ST
Mailing Address - Street 2:APT 3203
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06103-1500
Mailing Address - Country:US
Mailing Address - Phone:860-690-6399
Mailing Address - Fax:
Practice Address - Street 1:221 TRUMBULL ST
Practice Address - Street 2:APT 3203
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-1500
Practice Address - Country:US
Practice Address - Phone:860-690-6399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI169284246XS1301X
CT00092207246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography