Provider Demographics
NPI:1467119768
Name:MORFOGEN, ANTONIA J (CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:ANTONIA
Middle Name:J
Last Name:MORFOGEN
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:MISS
Other - First Name:ANTONIA
Other - Middle Name:JACLYN
Other - Last Name:MORFOGEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:43 S LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-2321
Mailing Address - Country:US
Mailing Address - Phone:845-657-1663
Mailing Address - Fax:
Practice Address - Street 1:43 S LIBERTY DR
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-2321
Practice Address - Country:US
Practice Address - Phone:845-533-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist