Provider Demographics
NPI:1376543744
Name:MORRIS, AMY (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MARCUS HOOK
Mailing Address - State:PA
Mailing Address - Zip Code:19061-4513
Mailing Address - Country:US
Mailing Address - Phone:610-859-8850
Mailing Address - Fax:610-859-7876
Practice Address - Street 1:283 SECOND STREET PIKE
Practice Address - Street 2:SUITE 145
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3823
Practice Address - Country:US
Practice Address - Phone:215-494-2255
Practice Address - Fax:215-494-2258
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01152900225100000X
PAPTO07918L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023825320001Medicaid
PA1376543744OtherBRAVO
PA30070675OtherKEYSTONE MERCY
PA002123203OtherPA BLUE SHIELD
PA3747921000OtherIBC
NJ22-2336723OtherCIGNA
NJ22-2336723OtherCIGNA
PAP00841763Medicare PIN