Provider Demographics
NPI:1194020545
Name:MORRESI MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:MORRESI MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRESI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-243-5854
Mailing Address - Street 1:199 BROAD ST
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2635
Mailing Address - Country:US
Mailing Address - Phone:800-243-5854
Mailing Address - Fax:888-501-0522
Practice Address - Street 1:199 BROAD ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2635
Practice Address - Country:US
Practice Address - Phone:800-243-5854
Practice Address - Fax:888-501-0522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08592100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty