Provider Demographics
NPI:1053846782
Name:MORALE, MICHAEL ALBERT (NP-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALBERT
Last Name:MORALE
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 CLARK PL
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7416
Mailing Address - Country:US
Mailing Address - Phone:908-358-5329
Mailing Address - Fax:
Practice Address - Street 1:456 CLARK PL
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7416
Practice Address - Country:US
Practice Address - Phone:908-358-5329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00729100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily