Provider Demographics
NPI:1275518409
Name:MORRIS, ELEAZAR C (MD)
Entity Type:Individual
Prefix:DR
First Name:ELEAZAR
Middle Name:C
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S BROAD ST STE 2230
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19110-1021
Mailing Address - Country:US
Mailing Address - Phone:267-704-9669
Mailing Address - Fax:267-541-2658
Practice Address - Street 1:100 S BROAD ST STE 2230
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19110-1021
Practice Address - Country:US
Practice Address - Phone:267-704-9669
Practice Address - Fax:267-541-2658
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226349207L00000X
PA451804207LA0401X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02657523Medicaid
NYI30441Medicare UPIN
NY02657523Medicaid