Provider Demographics
NPI:1164689188
Name:MORRIS WESTFRIED MD PC
Entity Type:Organization
Organization Name:MORRIS WESTFRIED MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:JACK
Authorized Official - Last Name:WESTFRIED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-837-9004
Mailing Address - Street 1:7508 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2502
Mailing Address - Country:US
Mailing Address - Phone:718-837-9004
Mailing Address - Fax:
Practice Address - Street 1:7508 15TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2502
Practice Address - Country:US
Practice Address - Phone:718-837-9004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127374207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00248164Medicaid
NY32404Medicare PIN
NY00248164Medicaid