1548597446 NPI number — DR. MICHELLE D. MORRISSEY, DPM, LLC

Table of content: (NPI 1548597446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548597446 NPI number — DR. MICHELLE D. MORRISSEY, DPM, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. MICHELLE D. MORRISSEY, DPM, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548597446
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
63 RAMSGATE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLUE BELL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19422-2550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-560-4985
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
406 NORRISTOWN RD
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
HORSHAM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19044-1250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-443-5709
Provider Business Practice Location Address Fax Number:
215-443-5716
Provider Enumeration Date:
11/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MORRISSEY
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
DANIELLE
Authorized Official Title or Position:
SOLE MEMBER/PRESIDENT
Authorized Official Telephone Number:
954-560-4985

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  SC005935 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com