Provider Demographics
NPI:1124552302
Name:PHIL MOR FIT
Entity Type:Organization
Organization Name:PHIL MOR FIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS PSYD CANDIDATE
Authorized Official - Phone:201-736-4811
Mailing Address - Street 1:1718 BELMONT AVE STE C-D
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL MD
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2552
Mailing Address - Country:US
Mailing Address - Phone:201-736-4811
Mailing Address - Fax:
Practice Address - Street 1:1718 BELMONT AVE STE C-D
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2552
Practice Address - Country:US
Practice Address - Phone:201-736-4811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty