Provider Demographics
NPI:1114943768
Name:CULPEPPER-MORGAN, JOAN A (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:A
Last Name:CULPEPPER-MORGAN
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 1:506 LENOX AVE
Mailing Address - Street 2:MLK 13-106
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1802
Mailing Address - Country:US
Mailing Address - Phone:212-939-1430
Mailing Address - Fax:212-939-1432
Practice Address - Street 1:506 LENOX AVE
Practice Address - Street 2:MLK 13-106
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-1430
Practice Address - Fax:212-939-1432
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029059207RG0100X
NY157259207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD85258Medicare UPIN