Provider Demographics
NPI:1346421070
Name:FATIHA, MORRIS
Entity Type:Individual
Prefix:MR
First Name:MORRIS
Middle Name:
Last Name:FATIHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 AVENUE V
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4504
Mailing Address - Country:US
Mailing Address - Phone:718-627-2689
Mailing Address - Fax:718-622-0289
Practice Address - Street 1:302 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3106
Practice Address - Country:US
Practice Address - Phone:718-871-1112
Practice Address - Fax:718-622-0289
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist