Provider Demographics
NPI:1093236390
Name:MORTON, STEPHANIE NOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:NOEL
Last Name:MORTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06098-2002
Mailing Address - Country:US
Mailing Address - Phone:860-738-3398
Mailing Address - Fax:
Practice Address - Street 1:80 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:CT
Practice Address - Zip Code:06098-2002
Practice Address - Country:US
Practice Address - Phone:860-738-3398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP04145207Q00000X
CT064892207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILP04145OtherRHODE ISLAND MEDICAL LICENSE
CT064892OtherCT LIC