Provider Demographics
NPI:1346285699
Name:MORRA, TRACY K (PT)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:K
Last Name:MORRA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 CARMAN RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303
Mailing Address - Country:US
Mailing Address - Phone:518-356-7445
Mailing Address - Fax:518-357-0018
Practice Address - Street 1:3434 CARMAN RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303
Practice Address - Country:US
Practice Address - Phone:518-356-7445
Practice Address - Fax:518-357-0018
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0184841225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01940716Medicaid
S89798Medicare UPIN
NY01940716Medicaid